title: Limitations of a Cardiac Risk (QRISK2) Calculator in Patients with High Density Lipoprotein (HDL).
abstract: BACKGROUND
  There is existing debate as to the relationship between blood concentration of HDL (high density lipoprotein) and cardiovascular outcomes. Patients with hyperalphalipoproteinaemia (HALP) have high HDL levels and this can be attributed to a variety of factors.
  
  
  OBJECTIVE
  This study aims for the first time to examine the HALP cohort and understand demographics, relationship with cardiovascular disease (CVD) risk and scoring with a cardiac risk calculator (QRISK 2 calculator).
  
  
  RESULTS
  The study found 42 patients had a statistically significant difference (p = 0.001) between CVD risk estimated using actual measured HDL (Score 1) versus CVD risk calculated using standard population mean HDL values (Score 2). Furthermore, in the CVD event group (n = 6) a significant difference was also seen between Score 1 and Score 2 (p = 0.027).
  
  
  CONCLUSIONS
  The study highlights issues with underestimation of CVD risk in this population and strongly advocates use of standard population mean values in assessment of CVD risk.
authors.affiliation: Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.|NIHR Leicester Cardiovascular Biomedical Research Unit, Leicester, UK.
authors.forename: Jatinder S
authors.initials: JS
authors.lastname: Minhas
authors.affiliation: Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.|NIHR Leicester Cardiovascular Biomedical Research Unit, Leicester, UK.|Department of Metabolic Medicine and Chemical Pathology, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors.forename: Prashanth
authors.initials: P
authors.lastname: Patel
authors.affiliation: Department of Cardiovascular Sciences, University of Leicester, Leicester, UK. pankaj.gupta@uhl-tr.nhs.uk.|NIHR Leicester Cardiovascular Biomedical Research Unit, Leicester, UK. pankaj.gupta@uhl-tr.nhs.uk.|Department of Metabolic Medicine and Chemical Pathology, University Hospitals of Leicester NHS Trust, Leicester, UK. pankaj.gupta@uhl-tr.nhs.uk.
authors.forename: Pankaj K
authors.initials: PK
authors.lastname: Gupta
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000209:etiology*; D053480:Cholesterol Ester Transfer Proteins / Q000097:blood / Q000172:deficiency*; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008052:Lipid Metabolism, Inborn Errors / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D053480:Cholesterol Ester Transfer Proteins; D008075:Lipoproteins, HDL
keywords: Cardiovascular Risk; Lipids; Primary Prevention