The clinical impact of estimating low-density lipoprotein cholesterol (LDL-C) using different equations in the general population

Autor: Reyna Lam, Sheila M. Manemann, Kristina E. Seehusen, Alan T. Remaley, Jennifer L. St. Sauver, Ruoxiang Jiang, Jill M. Killian, Maureen Sampson, Jeffrey W. Meeusen, Paul A. Decker, Véronique L. Roger, Paul Y. Takahashi, Nicholas B. Larson, Suzette J. Bielinski
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Lipids in Health and Disease, Vol 23, Iss 1, Pp 1-10 (2024)
Druh dokumentu: article
ISSN: 1476-511X
DOI: 10.1186/s12944-024-02188-9
Popis: Abstract Background Low-density lipoprotein cholesterol (LDL-C) is associated with atherosclerotic cardiovascular disease (ASCVD). Friedewald, Sampson, and Martin-Hopkins equations are used to calculate LDL-C. This study compares the impact of switching between these equations in a large geographically defined population. Materials and methods Data for individuals who had a lipid panel ordered clinically between 2010 and 2019 were included. Comparisons were made across groups using the two-sample t-test or chi-square test as appropriate. Discordances between LDL measures based on clinically actionable thresholds were summarized using contingency tables. Results The cohort included 198,166 patients (mean age 54 years, 54% female). The equations perform similarly at the lower range of triglycerides but began to diverge at a triglyceride level of 125 mg/dL. However, at triglycerides of 175 mg/dL and higher, the Martin-Hopkins equation estimated higher LDL-C values than the Samson equation. This discordance was further exasperated at triglyceride values of 400 to 800 mg/dL. When comparing the Sampson and Friedewald equations, at triglycerides are below 175 mg/dL, 9% of patients were discordant at the 70 mg/dL cutpoint, whereas 42.4% were discordant when triglycerides are between 175 and 400 mg/dL. Discordance was observed at the clinically actionable LDL-C cutpoint of 190 mg/dL with the Friedewald equation estimating lower LDL-C than the other equations. In a high-risk subgroup (ASCVD risk score > 20%), 16.3% of patients were discordant at the clinical cutpoint of LDL-C
Databáze: Directory of Open Access Journals
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