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Related Experiment Videos

How should low-density lipoprotein cholesterol concentration be determined?

Fred H Faas1, Ashley Earleywine, Grady Smith

  • 1VA Hospital, 4300 W. 7th, Little Rock, AR 72205, USA. faasfredh@uams.edu

The Journal of Family Practice
|December 18, 2002
PubMed
Summary

Directly measured LDL-C is significantly higher than calculated LDL-C, potentially leading to overtreatment. The National Cholesterol Education Program Adult Treatment Panel III Report (NCEP-ATP III) recommends calculated LDL-C for cholesterol therapy decisions.

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Area of Science:

  • Cardiovascular Medicine
  • Clinical Chemistry
  • Biochemistry

Background:

  • Low-density lipoprotein cholesterol (LDLC) is a primary therapeutic target.
  • The National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) recommends using Friedewald calculated LDL-C (C-LDL-C).

Purpose of the Study:

  • To compare direct LDL-C (D-LDL-C) with C-LDL-C.
  • To assess the impact of D-LDL-C on NCEP-ATP III treatment decisions.

Main Methods:

  • Comparison of D-LDL-C and C-LDL-C assays.
  • Analysis of 464 consecutive patient samples.

Main Results:

  • D-LDL-C was 18% higher than C-LDL-C at the critical 100 mg/dL threshold.
  • Discrepancies can lead to inappropriate drug therapy, primarily overtreatment.

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Conclusions:

  • Following NCEP-ATP III guidelines with D-LDL-C may result in unnecessary cholesterol-lowering drug use.
  • C-LDL-C remains preferred due to its use in clinical trials validating cholesterol-lowering therapy benefits.