Author + information
- Vasanth Sathiyakumara,b,
- Asieh Golozara,b,
- Mariana Lazoa,b,
- Renato Quispea,b,
- Eliseo Guallara,b,
- Roger Blumenthala,b,
- Steven Jonesa,b and
- Seth Martina,b
Background: New recommendations favoring non-fasting lipid assessment may impact accuracy of low-density lipoprotein-cholesterol (LDL-C) estimation, especially at low levels. The novel method (LDL-CN) of LDL-C estimation, using a flexible 180-cell approach, may offer an advantage in non-fasting patients over the classic Friedewald method (LDL-CF) that uses a fixed approach.
Methods: In 1,545,677 patients from the VLDL study, we compared concordance of LDL-CN and LDL-CF with LDL-C directly measured by ultracentrifugation (LDL-CD). With results stratified by fasting status, concordance was classified by clinical LDL-C cutpoints: 70, 100, 130, 160, and 190 mg/dL. For low LDL-C (<70 mg/dL), we also stratified by triglycerides (TG).
Results: Compared to LDL-CF, concordance was higher between LDL-CN and LDL-CD across all LDL-C categories. In addition, concordance in LDL-CN was less affected by non-fasting (all >86%) (Table). With LDL-C <70 mg/dL, the concordance difference between LDL-CN non-fasting (92%) and fasting (94%) groups was smaller than for LDL-CF (71% and 78% respectively). Concordance decreased in both methods inversely to TG and regardless of fasting status. Yet, even with TG 200-399 mg/dL, LDL-CN <70 mg/dL concordance was 82% in non-fasting patients compared to 37% concordance in LDL-CF.
Conclusions: In non-fasting samples, accuracy of novel LDL-C estimation appears less adversely affected than Friedewald estimation, with a particular advantage in the setting of low LDL-C and high TG.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Advances in Cholesterol Measurement and Management
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1106-043
- 2017 American College of Cardiology Foundation