The July 28th issue of the Journal of the American College of Cardiology included a new meta-analysis of eight clinical trials of patients on statin therapy (n=38,153). Since no randomized clinical trials have been designed to look at clinical outcomes based on LDL targets, investigators looked at data from these clinical trials and decided that a mean LDL-cholesterol (LDL-C) level of 175 mg/dL would serve as the reference group. They then looked at outcome data in those subjects with LDL levels in 3 lower groups (i.e., subjects with LDL-C of 75 to <100 mg/dL, 50 to <75 mg/dL and those <50 mg/dL) and found convincing evidence that subjects with lower LDL-C levels had significant reductions in cardiovascular event rates as compared to the mean.
Reference: Boekholdt SM, Hovingh GH, Mora S, et al. Very low levels of atherogenic lipoproteins and the risk for cardiovascular events: A meta-analysis of statin trials. J Am Coll Cardiol. 2014; 64:485-494. doi: 10.1016/j.jacc.2014.02.615