J-shaped association between LDL cholesterol and cardiovascular events: A longitudinal primary prevention cohort of over 2.4 million people nationwide

•In this nationwide primary prevention cohort study, about two-thirds of the subjects had a 10-year ASCVD risk of <5 %.•J-shaped associations were observed between MI risk, IS risk, and LDL cholesterol levels.•Associations between MI and IS risks and LDL cholesterol levels were influenced by ASCVD risk and obesity.•A J-shaped association was observed between hs-CRP level and LDL cholesterol level.•Therefore, low LDL cholesterol levels with no statin medication do not warrant safety from ASCVD.