# Ez-PAVE: LDL-streefwaarde <55 mg/dL superieur aan <70 mg/dL bij patiënten met atherosclerotisch vaatlijden

*geplaatst 2026-03-28 · Cholesterol · The New England Journal of Medicine · doi https://www.nejm.org/doi/full/10.1056/NEJMoa2600757 · https://hartvaat.nl/2026/03/28/ez-pave-ldl-streefwaarde-55-mg-dl-superieur-aan-70-mg-dl-bij-patienten-met-ather/*

In de Ez-PAVE-trial, de eerste gerandomiseerde head-to-head vergelijking van LDL-cholesterolstreefwaarden, werd bij 3.048 patiënten met atherosclerotisch vaatlijden aangetoond dat een streefwaarde van <55 mg/dL het risico op cardiovasculaire events met 33% verlaagt ten opzichte van <70 mg/dL (HR 0,67; P=0,002). Na 3 jaar trad het primaire samengestelde eindpunt op bij 6,6% versus 9,7%. Het veiligheidsprofiel was vergelijkbaar. Dit is het eerste gerandomiseerde bewijs dat de lagere streefwaarde uit de ACC/AHA-richtlijn 2026 daadwerkelijk superieur is.

## English: 

In the Ez-PAVE trial, the first randomized head-to-head comparison of LDL-C targets, 3,048 patients with ASCVD were shown to have a 33% lower risk of cardiovascular events with a target of <55 mg/dL vs <70 mg/dL (HR 0.67; P=0.002). At 3 years, the primary composite endpoint occurred in 6.6% vs 9.7%. Safety profiles were similar. This is the first randomized evidence that the lower target in the 2026 ACC/AHA dyslipidemia guideline is superior.

## Abstract (original, from the publication)

Background: Randomized evidence evaluating the optimal low-density lipoprotein (LDL) cholesterol target for secondary prevention in patients with atherosclerotic cardiovascular disease (ASCVD) remains limited. Methods: In this multicenter, randomized, open-label, superiority trial, we randomly assigned 3048 patients with ASCVD to a target LDL cholesterol level of <55 mg/dL (intensive targeting) or <70 mg/dL (conventional targeting). The primary endpoint was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, any revascularization, or hospitalization for unstable angina at 3 years. Results: A total of 1526 patients were assigned to the intensive-targeting group and 1522 to the conventional-targeting group. The median follow-up was 3.0 years. The median LDL cholesterol level during the study was 56 mg/dL in the intensive-targeting group and 66 mg/dL in the conventional-targeting group. A primary endpoint occurred in 100 patients (6.6%) in the intensive-targeting group and in 147 patients (9.7%) in the conventional-targeting group (hazard ratio, 0.67; 95% confidence interval, 0.52-0.86; P=0.002). The incidence of prespecified safety endpoints was similar between the groups, except for a lower incidence of creatinine elevation in the intensive-targeting group. Conclusion: In patients with ASCVD, targeting an LDL cholesterol level of <55 mg/dL resulted in a lower risk of cardiovascular events than targeting a level of <70 mg/dL.

Auteurs: Byeong-Keuk Kim, Yong-Joon Lee, Seung-Jun Lee et al.

---
Bron: The New England Journal of Medicine, https://doi.org/https://www.nejm.org/doi/full/10.1056/NEJMoa2600757. Bijgewerkt 2026-07-03T13:31:12Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.