Concordance of LDL-cholesterol levels between the Friedewald, Martin/Hopkins, and Sampson equations in patients with atherosclerotic cardiovascular disease

Aparna Sajja; Hsin-Fang Li; Kateri Spinelli; Salim S. Virani; Seth S. Martin; Gluckman Tyler J

Concordance of LDL-cholesterol levels between the Friedewald, Martin/Hopkins, and Sampson equations in patients with atherosclerotic cardiovascular disease

Aparna Sajja, Hsin-Fang Li, Kateri Spinelli, Salim S. Virani, Seth S. Martin, Gluckman Tyler J

Research output: Other contribution

Abstract

Introduction: Accurate estimation of low-density lipoprotein cholesterol (LDL-C) is important for cardiovascular risk assessment and guiding cholesterol-lowering therapy. Different methods currently exist to estimate LDL-C. There is limited data in patients with atherosclerotic cardiovascular disease (ASCVD) in prior studies.

Objectives: To assess concordance of estimated LDL-C using the Friedewald, Martin/Hopkins, and Sampson equations.

Methods: We performed a retrospective analysis of electronic health record data from a large multistate healthcare system. Patients with ASCVD and triglycerides (TG)

Results: The study included 146,106 patients with ASCVD (median age 68 years, 56% male, and 91% White). Discordance rates were 15% for the Friedewald vs Martin/Hopkins comparison, 9% for the Friedewald vs Sampson comparison, and 7% for the Sampson vs Martin/Hopkins comparison. Estimated LDL-C was lower for the Friedewald and Sampson equations compared to the Martin/Hopkins equation. Discordance was more pronounced at lower LDL-C cut points and in those with TG ≥150 mg/dL.

Conclusions: Important differences in estimated LDL-C exist between the three equations, particularly among those with TG ≥150 mg/dL. These results in ASCVD patients, synthesized with prior evidence, raise concern that reliance upon the Friedewald and Sampson equations may result in underestimation and thus, undertreatment of LDL-C in those at increased risk.

Original language	Undefined/Unknown
State	Published - Nov 1 2021

Publication series

Name	Articles, Abstracts, and Reports

Access to Document

http://digitalcommons.psjhealth.org/publications/5427

Cite this

@misc{093d05b7b24845e0b799c6d73bd4ba72,

title = "Concordance of LDL-cholesterol levels between the Friedewald, Martin/Hopkins, and Sampson equations in patients with atherosclerotic cardiovascular disease",

abstract = "Introduction: Accurate estimation of low-density lipoprotein cholesterol (LDL-C) is important for cardiovascular risk assessment and guiding cholesterol-lowering therapy. Different methods currently exist to estimate LDL-C. There is limited data in patients with atherosclerotic cardiovascular disease (ASCVD) in prior studies. Objectives: To assess concordance of estimated LDL-C using the Friedewald, Martin/Hopkins, and Sampson equations. Methods: We performed a retrospective analysis of electronic health record data from a large multistate healthcare system. Patients with ASCVD and triglycerides (TG) Results: The study included 146,106 patients with ASCVD (median age 68 years, 56% male, and 91% White). Discordance rates were 15% for the Friedewald vs Martin/Hopkins comparison, 9% for the Friedewald vs Sampson comparison, and 7% for the Sampson vs Martin/Hopkins comparison. Estimated LDL-C was lower for the Friedewald and Sampson equations compared to the Martin/Hopkins equation. Discordance was more pronounced at lower LDL-C cut points and in those with TG ≥150 mg/dL. Conclusions: Important differences in estimated LDL-C exist between the three equations, particularly among those with TG ≥150 mg/dL. These results in ASCVD patients, synthesized with prior evidence, raise concern that reliance upon the Friedewald and Sampson equations may result in underestimation and thus, undertreatment of LDL-C in those at increased risk.",

author = "Aparna Sajja and Hsin-Fang Li and Kateri Spinelli and Virani, {Salim S.} and Martin, {Seth S.} and {Tyler J}, Gluckman",

year = "2021",

month = nov,

day = "1",

language = "Undefined/Unknown",

series = "Articles, Abstracts, and Reports",

type = "Other",

}

TY - GEN

T1 - Concordance of LDL-cholesterol levels between the Friedewald, Martin/Hopkins, and Sampson equations in patients with atherosclerotic cardiovascular disease

AU - Sajja, Aparna

AU - Li, Hsin-Fang

AU - Spinelli, Kateri

AU - Virani, Salim S.

AU - Martin, Seth S.

AU - Tyler J, Gluckman

PY - 2021/11/1

Y1 - 2021/11/1

N2 - Introduction: Accurate estimation of low-density lipoprotein cholesterol (LDL-C) is important for cardiovascular risk assessment and guiding cholesterol-lowering therapy. Different methods currently exist to estimate LDL-C. There is limited data in patients with atherosclerotic cardiovascular disease (ASCVD) in prior studies. Objectives: To assess concordance of estimated LDL-C using the Friedewald, Martin/Hopkins, and Sampson equations. Methods: We performed a retrospective analysis of electronic health record data from a large multistate healthcare system. Patients with ASCVD and triglycerides (TG) Results: The study included 146,106 patients with ASCVD (median age 68 years, 56% male, and 91% White). Discordance rates were 15% for the Friedewald vs Martin/Hopkins comparison, 9% for the Friedewald vs Sampson comparison, and 7% for the Sampson vs Martin/Hopkins comparison. Estimated LDL-C was lower for the Friedewald and Sampson equations compared to the Martin/Hopkins equation. Discordance was more pronounced at lower LDL-C cut points and in those with TG ≥150 mg/dL. Conclusions: Important differences in estimated LDL-C exist between the three equations, particularly among those with TG ≥150 mg/dL. These results in ASCVD patients, synthesized with prior evidence, raise concern that reliance upon the Friedewald and Sampson equations may result in underestimation and thus, undertreatment of LDL-C in those at increased risk.

AB - Introduction: Accurate estimation of low-density lipoprotein cholesterol (LDL-C) is important for cardiovascular risk assessment and guiding cholesterol-lowering therapy. Different methods currently exist to estimate LDL-C. There is limited data in patients with atherosclerotic cardiovascular disease (ASCVD) in prior studies. Objectives: To assess concordance of estimated LDL-C using the Friedewald, Martin/Hopkins, and Sampson equations. Methods: We performed a retrospective analysis of electronic health record data from a large multistate healthcare system. Patients with ASCVD and triglycerides (TG) Results: The study included 146,106 patients with ASCVD (median age 68 years, 56% male, and 91% White). Discordance rates were 15% for the Friedewald vs Martin/Hopkins comparison, 9% for the Friedewald vs Sampson comparison, and 7% for the Sampson vs Martin/Hopkins comparison. Estimated LDL-C was lower for the Friedewald and Sampson equations compared to the Martin/Hopkins equation. Discordance was more pronounced at lower LDL-C cut points and in those with TG ≥150 mg/dL. Conclusions: Important differences in estimated LDL-C exist between the three equations, particularly among those with TG ≥150 mg/dL. These results in ASCVD patients, synthesized with prior evidence, raise concern that reliance upon the Friedewald and Sampson equations may result in underestimation and thus, undertreatment of LDL-C in those at increased risk.

M3 - Other contribution

T3 - Articles, Abstracts, and Reports

ER -