Secondary Prevention - Science topic

Chih Hao Chen-Ku is right !! However, Odyssey is the "longest" study on PCSK9 inhibitors, is a phase 3 Study (!) on FH heterozygous patients (plus other no well classified HLP), with a follow up of max 3 yr if I remember well ! In my opinion, low LDLc may cause problems in several cell functions in the long period. Human newborn have very low "natural" LDLc level and live well (!), but the mean values is about 50+ mg/dL of LDLc !!!!  (30-70). The "low plasma LDL cholesterol" in adults is a complex (and "thorny") problem. 

Regards

A

Each organissation develops their own clinical guidelines. Depending on your research you should target each country and the national organisation in charge of developing the guidelines. For Spain you can find the information on this website: :http://portal.guiasalud.es/web/guest/guias-practica-clinica. they collect all the different clinical guidelines developed by the different regional governments (17 in Spain), so usually if they exist you can find them on this website, if not I;m afraid that you should contact each autonomous community  one by one.

You could contact Guia Salud (through the website)and ask if they keep track of old guidelines.

For European Countries having different regional health governments (Germany, Italy) you will probably face the same problems of non-centralised information.

For UK, they use the guidelines of NECP , ATP III, as mentioned ,through the NIH you can find them easily on their website, the one I found is from 2002 and I also  found an 2004 update in an interesting  article: http://www.nhlbi.nih.gov/files/docs/guidelines/atp3upd04.pdf    ,page 237

the best evidence so far was collected by goldstein regarding the use of aspirin:

1. The use of aspirin for cardiovascular (including but not specific to stroke) prophylaxis is recommended for persons whose risk is sufficiently high for the benefits to outweigh the risks associated with treat- ment (a 10-year risk of cardiovascular events of 6% to 10%) (Class I; Level of Evidence A).

2. Aspirin (81 mg daily or 100 mg every other day) can be useful for prevention of a first stroke among women whose risk is sufficiently high for the benefits to outweigh the risks associated with treatment (Class IIa; Level of Evidence B).

3. Aspirin is not useful for preventing a first stroke in persons at low risk (Class III; Level of Evidence A).

this can be found in this article:

Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S, et al. Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011. pp. 517–84.

also regarding aspirin as primary stroke prevention:

McCarthy M. FDA questions use of aspirin for primary prevention of stroke and heart attack. BMJ. 2014;:g3168.