Ultra-Low LDL Target (55 mg/dL) Cuts Events in ASCVD: Ez-PAVE
In the Ez-PAVE randomized trial of 3,048 ASCVD patients across 17 Korean sites, aiming for an intensive LDL target of <55 mg/dL vs a conventional <70 mg/dL reduced the 3-year composite of cardiovascular death, nonfatal MI, nonfatal stroke, revascularization, or unstable-angina hospitalization by 33% (HR 0.67). Intensive targeting achieved median LDL of 56 mg/dL vs 66 mg/dL, with higher use of ezetimibe and high‑intensity statins; safety was similar between groups. The findings, published alongside updated guidelines, support lower LDL goals in secondary prevention and note ezetimibe-first strategies as cost-effective before PCSK9 inhibitors. Notably, the benefit for women was not evident, likely due to limited power.