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01.11.2018 | Lipids (E. Michos, Section Editor)

Time to Make a Change: Assessing LDL-C Accurately in the Era of Modern Pharmacotherapeutics and Precision Medicine

verfasst von: Vincent A. Pallazola, Renato Quispe, Mohamed B. Elshazly, Rachit Vakil, Vasanth Sathiyakumar, Steven R. Jones, Seth S. Martin

Erschienen in: Current Cardiovascular Risk Reports | Ausgabe 11/2018

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Abstract

Purpose of Review

The Friedewald equation for estimation of low-density lipoprotein cholesterol (LDL-C) was published in 1972 as an alternative to direct assessment by preparative ultracentrifugation. In this equation, very low-density lipoprotein is estimated by dividing triglycerides by a fixed factor (5 in mg/dL or 2.2 in mmol/L) and subtracting this term from non-high-density lipoprotein cholesterol (non-HDL-C). This method was derived in fasting samples from a small cohort of patients with primarily genetic dyslipidemias followed at the NIH. The method served well as the global standard for LDL-C estimation for decades, but is not well suited to modern clinical practice because it tends to underestimate LDL-C at low LDL-C and high triglyceride levels. The concern is that underestimation could lead to undertreatment in high-risk patients.

Recent Findings

Derived from big data and now validated around the world, a novel LDL-C equation created at Johns Hopkins replaces the fixed factor seen in the classic equation with a patient-specific variable based on triglyceride and non-HDL-C levels.

Summary

Given its superior accuracy in fasting and non-fasting populations alike, the novel equation is now the preferred method for LDL-C estimation and is being incorporated by leading clinical laboratories.

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Titel: Time to Make a Change: Assessing LDL-C Accurately in the Era of Modern Pharmacotherapeutics and Precision Medicine
verfasst von: Vincent A. Pallazola
Renato Quispe
Mohamed B. Elshazly
Rachit Vakil
Vasanth Sathiyakumar
Steven R. Jones
Seth S. Martin
Publikationsdatum: 01.11.2018
Verlag: Springer US
Erschienen in: Current Cardiovascular Risk Reports / Ausgabe 11/2018
Print ISSN: 1932-9520
Elektronische ISSN: 1932-9563
DOI: https://doi.org/10.1007/s12170-018-0590-9

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Springer Medizin

Time to Make a Change: Assessing LDL-C Accurately in the Era of Modern Pharmacotherapeutics and Precision Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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Triglyzeridsenker schützt nicht nur Hochrisikopatienten

Gibt es eine Wende bei den bioresorbierbaren Gefäßstützen?

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Darf man die Behandlung eines Neonazis ablehnen?

Update Kardiologie

Klimawandel und Gesundheit: Was Sie in der Hausarztpraxis wissen müssen und tun können

Springer Medizin

Abstract

Purpose of Review

Recent Findings

Summary

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Neu im Fachgebiet Kardiologie

Triglyzeridsenker schützt nicht nur Hochrisikopatienten

Gibt es eine Wende bei den bioresorbierbaren Gefäßstützen?

Vorsicht, erhöhte Blutungsgefahr nach PCI!

Darf man die Behandlung eines Neonazis ablehnen?

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