“I Don’t Need Those Pills”—Until the Second Heart Attack

In a world tired of statin falsehoods, the data from Ez‑PAVE draw a simple line—those who drove LDL lower, had lower risk of recurrent cardiac events

Peter A. McCullough, MD, MPH

I personally try to keep my LDL-C < 40 mg/dl with a statin + ezetimibe given the presence of atherosclerotic heart disease. But is lower really better? Alter AI summarized the Ez‑PAVE Trial (Lee et al., NEJM, 2026) presented at ACC 2026.

The Ez‑PAVE (Ezetimibe – Practical Approach to Very‑low LDL Evaluation) trial was a multicenter, randomized, open‑label study comparing two low‑density lipoprotein cholesterol (LDL‑C) targets in patients with established atherosclerotic cardiovascular disease (ASCVD). Conducted at 17 sites in South Korea from 2021 to 2022, the trial enrolled 3,048 participants (mean age ≈ 64 years, 21 % women) with prior myocardial infarction, stroke, stable angina, or peripheral artery disease.