If a patient has coronary artery disease or diabetes mellitus, what is the target LDL level?

For patients with coronary artery disease (CAD) or diabetes mellitus, the target LDL cholesterol level is less than 70 mg/dL. This goal is established based on evidence indicating that lower LDL levels are associated with a reduction in cardiovascular events and overall morbidity and mortality in high-risk populations.

In patients with CAD, achieving an LDL level of less than 70 mg/dL has been shown to provide additional cardiovascular protection beyond the standard targets, and aggressive lipid-lowering therapy, often with statins or other medications, may be warranted to reach this target. Similarly, for individuals with diabetes, particularly those with additional risk factors, the same target helps to manage their overall risk of cardiovascular disease.

While lower targets, such as less than 50 mg/dL, can be beneficial in certain high-risk cases, they are not generally recommended as standard targets for all patients with CAD or diabetes. A target of less than 100 mg/dL or a range of 70-100 mg/dL does not provide the same level of evidence-based protection against cardiovascular events in high-risk patients compared to an LDL target of less than 70 mg/dL.