E-Abstract

JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2023. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-047

Comparison of Estimated LDL Cholesterol Equations With Direct Measurement in Patients With Coronary Artery Disease

By Haoyu Wang, Kefei Dou

Presenter

Haoyu Wang

Authors

Haoyu Wang1, Kefei Dou1

Affiliation

Fuwai Hospital, China1
View Study Report
TCTAP A-047
Pharmacology/Pharmacotherapy

Comparison of Estimated LDL Cholesterol Equations With Direct Measurement in Patients With Coronary Artery Disease

Haoyu Wang1, Kefei Dou1

Fuwai Hospital, China1

Background

Our goals in the study were to (1) quantify the discordance in LDL-C levels between equations (the Friedewald, Sampson, and Martin/Hopkins equations) and compare them with direct LDL-C (dLDL-C); and (2) explore the proportion of misclassified patients by calculated LDL-C using these three different equations.

Methods

A total of 30,349 consecutive patients with angiographically confirmed coronary artery disease (CAD) were prospectively enrolled. Concordance was defined as if the LDL-C was <1.8 mmol/L with each pairwise comparison of LDL-C equations. Estimated LDL-C that fell into the same category as dLDL-C at the following levels: <1.4, 1.4 to 1.7, 1.8 to 2.5, 2.6 to 2.9, and ≥3.0 mmol/L was considered to have been correctly categorized.

Results

The Martin/Hopkins and Sampson equation demonstrated a greater connection with direct LDL-C at all levels compared to the Friedewald equation. Based on an LDL-C threshold of 1.8 mmol/L, the concordance was 96.3% (Sampson vs. Martin/Hopkins), 95.0% (Friedewald vs. Sampson), and 91.4% (Friedewald vs. Martin/Hopkins), respectively. The Sampson and Martin/Hopkins equation’s concordance is superior to that of the other combinations. The concordance proportion across the three equations (consistently estimating the LDL-C as <1.8 mmol/L) was 91.4% for all patients. This proportion fell to 82.4% in those with hypertriglyceridemia (TG ≥ 1.7 mmol/L). With an accurate classification rate of 73.6%, the Martin/Hopkins equation outperformed the Sampson equation (69.5%) and the Friedewald equation (59.3%) by a wide margin at the following LDL-C levels: <1.4, 1.4 to 1.7, 1.8 to 2.5, 2.6 to 2.9, and ≥3.0 mmol/L.

Conclusion

Comparing it to the validated Martin/Hopkins equation, the Friedewald equation produced the lowest levels of LDL-C, followed by the Sampson equation. In the classification of LDL-C, the Martin/Hopkins equation has also been shown to be more accurate. There is a significant difference between the equations and the direct measurement method, which may lead to overtreatment or undertreatment.

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