Researchers have developed and validated a novel method to estimate low-density lipoprotein cholesterol (LDL-C) that offers accuracy advantages over traditional estimation methods, according to a study published Nov. 20 in the Journal of the American Medical Association (JAMA). If validated, the authors say, this method could be implemented into practice through “most laboratory reporting systems at virtually no cost.” “It is remarkable how well the [Friedewald] equation has withstood the test of time. Nevertheless, Friedewald et al recognized that inaccuracies in very LDL-C (VLDL-C) estimation could become more important at lower cholesterol concentrations and higher triglyceride concentrations,” write the authors, led by Seth Martin, M.D., from Johns Hopkins in Baltimore. LDL-C estimates eliminate the need for ultracentrifugation needed with direct LDL-C measures and are widely used in international recommendations to guide treatment. The most common estimation method is the Friedewald equation, which assumes a fixed ratio of 5-to-1 for triglycerides to VLDL-C (TG:VLDL-C). However, the authors say, this fixed ratio is “problematic” given the actual TG:VLDL-C ratio varies significantly across the range of triglyceride and cholesterol levels. Additionally, the currently used 70 mg/dL secondary prevention target is well below the LDL values seen in the data set used to derive […]