Case report. LDL increased after withdrawal of lovastatin therapy: Does it make sense to resume treatment given that, according to the latest important retrospective cohort study, LDL is not a true risk factor for cardiovascular disease?

Abstract

Low density lipoprotein (LDL) cholesterol for decades has been considered the primary risk factor for cardiovascular diseases. The pharmaceutical research has developed effective drugs that lower blood LDL levels. The most effective drugs belong to the class of statins, which act as reversible enzyme inhibitors of the mevalonate pathway, which is involved in the biosynthesis of cholesterol and other steroid metabolites. Statins, in a significant percentage of users, cause side effects, especially muscle-related ones, which prevent continuation of therapy. Once therapy is stopped, blood LDL levels inevitably rise to their pre-treatment levels, which are therefore above the "optimal" threshold defined by scientific literature (