Why do heart attacks still happen even when cholesterol is very low?
Exploring residual cardiovascular risk beyond LDL cholesterol in patients with acute destabilisation of known significant atherosclerosis
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
Surprising Findings
Patients with very low LDL cholesterol (<55 mg/dL) had higher unadjusted risks of dying in the hospital and over time after a heart attack.
This seems to contradict the common belief that lower cholesterol is always better. It could make people question if pushing cholesterol too low is harmful — but the study shows this risk vanishes when other factors are considered.
Practical Takeaways
If you have heart disease, reaching an LDL below 55 mg/dL is important, but don’t assume it fully protects you — other risk factors still matter.
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
Surprising Findings
Patients with very low LDL cholesterol (<55 mg/dL) had higher unadjusted risks of dying in the hospital and over time after a heart attack.
This seems to contradict the common belief that lower cholesterol is always better. It could make people question if pushing cholesterol too low is harmful — but the study shows this risk vanishes when other factors are considered.
Practical Takeaways
If you have heart disease, reaching an LDL below 55 mg/dL is important, but don’t assume it fully protects you — other risk factors still matter.
Publication
Journal
European Heart Journal
Year
2025
Authors
L. Bavuso, D. Fedele, S. Amicone, A. Maida, M. Basile, R. Belà, C. Asta, M. Di Leo, T. Manaresi, M. Ciarlantini, G. Pastore, M. Casuso, A. Sansonetti, A. Rinaldi, C. Pizzi
Related Content
Claims (4)
If you've already had heart problems, keeping your 'bad' cholesterol really low—below 55—might help prevent future heart attacks or strokes compared to aiming for a higher level.
If someone with heart disease has a very low 'bad' cholesterol level when they’re admitted for a heart attack, they might be more likely to die in the hospital or later on — but this link goes away when you account for how sick they were overall.
Even when people with heart disease have really low 'bad' cholesterol, some still have heart attacks — showing that low cholesterol alone doesn’t eliminate all heart risks.
If someone with heart disease has a heart attack, fixing blocked arteries might help more if their 'bad' cholesterol was already low when they arrived at the hospital.