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Revista Colombiana de Cardiología
Print version ISSN 0120-5633
Abstract
MERCHAN, Alonso. In patients at high risk, the lower the low density cholesterol (c-LDL), the better: How low and which is its grade of recommendation and evidence level?. Rev. Col. Cardiol. [online]. 2008, vol.15, n.4, pp.165-172. ISSN 0120-5633.
After the publication of the last guidelines of the Panel on Treatment in Adults of the National Cholesterol Education Program III of the United States of America (ATPIII-NCEP) -year 2004- (1), several studies and methanalysis (9-19) have been published, assigning a clearer value to the concept «the lower the better» for the goals on low density cholesterol (c-LDL). According to the last evidences, in the group of high risk patients, a recommendation I is proposed, with evidence level A (IA), for a c-LDL < 100 mg/dL goal and a recommendation II with evidence level A, IIa (A), for a c-LDL < 70-75 mg/dL goal. Likewise, the classification of high and very high risk proposed by the NCEP-ATPIII (1) does not seem to be justified, given that in both categories the objectives or goals in the c-LDL are similar. A table (Table 3) was designed that allows calculating the goal or objective of c-LDL in a simple and practical way, according to the global risk of an individual.
Keywords : low density cholesterol (c-LDL); high risk; ATPIII-NCEP Guidelines; recommendation; evidence level; myocardial infarction; coronary death.