How should low-density lipoprotein cholesterol concentration be determined?
The National Cholesterol Education Program Adult Treatment Panel III Report (NCEP-ATP III) has identified low-density lipoprotein cholesterol (LDLC) as the primary target of therapy and has recommended using the Friedewald calculated LDL-C (CLDL- C). The present study compared a direct LDLC (D-LDL-C) method with the C-LDL-C and determined the possible impact on treatment decisions. C-LDL-C and D-LDL-C were compared in 464 consecutive patients. The D-LDL-C was 18% higher than the C-LDL-C at 100 mg/dL, an important level for medical decision making. This can result in inappropriate drug therapy (usually overtreatment) if the NCEP-ATP III treatment guidelines are followed with the D-LDL-C rather than the C-LDL-C. The C-LDL-C is preferred because this assay has been used in clinical trials documenting the benefits of cholesterol-lowering therapy.
Faas
Fred H
FH
VA Hospital, 4300 W. 7th, Little Rock, AR 72205, USA. faasfredh@uams.edu
Earleywine
Ashley
A
Smith
Grady
G
Simmons
Debra L
DL
D000924:Anticholesteremic Agents / Q000008:administration & dosage; D001774:Blood Chemical Analysis / Q000379:methods*; D008078:Cholesterol, LDL / Q000032:analysis* / Q000097:blood*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D016014:Linear Models; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL