What do lipidologists think is the right LDL-P goal for our highest risk patients? Looking at Dr. Dall's chart in Summer, 2011, Lipid Spin (p. 20) suggests a percentile equivalent goal to the NCEP, AHA, ADA recommendation of LDL<70 would translate to to an NMR LDL-P that could be <700. Yet I suspect that many of our clinical studies, such as TNT, indicate that the clinical benefit seen from an LDL <70 in high risk patients usually represents a discordant LDL-P of much higher value. The improvement in clinical events comes from lowering the terrible LDL-P to one that is lower. I think one of the chemistry/lab societies has recommended an LDL-P goal of <1100 for high risk patients. To get all my high risk patients to an LDL-P#<700 is going to take a lot of drugs! What say ye, Lipidologists?
