Does extreme reduction in LDL cholesterol with statin therapy increase morbidity and mortality?

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Regardless of baseline low-density lipoprotein (LDL) level, larger absolute LDL reductions result in risk reductions for major vascular events (MVEs), but may increase risk for some adverse outcomes. Each 39-mg/dL reduction in LDL reduces MVEs by 22% and reduces vascular mortality by 14% (SOR: A, meta-analysis). Very low LDL (<30 mg/dL) is associated with adverse outcomes, such as diabetes and hepatobiliary, renal, urinary, and psychiatric disorders (SOR: C, subanalysis of a RCT).

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