Summary
This European Atherosclerosis Society consensus statement synthesises evidence from over 200 prospective cohort studies, genetic investigations, and randomised intervention trials to establish that LDL causes ASCVD. The panel demonstrates a consistent dose-dependent relationship between vascular exposure to LDL-C and ASCVD risk, with effect magnitude increasing with duration of exposure. The evidence unifies findings from naturally randomised genetic studies with intervention trials, supporting that any mechanism reducing LDL particle concentration should proportionally reduce ASCVD risk.
UK applicability
These findings are directly applicable to UK clinical practice and cardiovascular health policy, underpinning current National Health Service guidance on lipid management and LDL-lowering therapies. The evidence base supports existing UK recommendations for LDL-C targets in primary and secondary prevention of cardiovascular disease.
Key measures
Dose-dependent log-linear association between plasma LDL cholesterol (LDL-C) and ASCVD risk; LDL particle concentration; absolute reduction in LDL-C; cumulative duration of LDL-C exposure; cardiovascular events
Outcomes reported
The study appraised clinical and genetic evidence establishing whether low-density lipoproteins (LDL) cause atherosclerotic cardiovascular disease (ASCVD). It evaluated evidence from genetic studies, prospective epidemiologic cohorts, Mendelian randomization studies, and randomized trials of LDL-lowering therapies, encompassing over 2 million participants and 150,000 cardiovascular events.
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