Impact of the Martin/Hopkins modified equation for estimating LDL-C on lipid target attainment in a high risk patient population |
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| Institution: | 1. National Cerebral and Cardiovascular Center, Department of Preventive Cardiology, Lipid Reference Laboratory, Japan;2. Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Japan;3. Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Japan;4. Osaka Center for Cancer and Cardiovascular Disease Prevention, Japan;5. National Cerebral and Cardiovascular Center, Department of Preventive Medicine and Epidemiologic Informatics, Office of Evidence-based Medicine and Risk Analysis, Japan;6. National Cerebral and Cardiovascular Center, Department of Preventive Medicine and Epidemiologic Informatics, Japan;7. Ministry of Health, Labour and Welfare, Health Service Bureau, Cancer Control and Health Promotion Division, Japan;8. Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, USA;9. National Cerebral and Cardiovascular Center, Department of Preventive Cardiology, Department of Preventive Medicine and Epidemiologic Informatics, Japan;1. Departments of Medicine and Biochemistry, University of Alberta, Edmonton, AB, Canada;2. Department of Clinical Chemistry, Central Diagnostic Laboratory, Maastricht University Medical Center, Maastricht, The Netherlands;3. Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada |
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| Abstract: | ObjectiveTo evaluate the Martin/Hopkins equation for estimating LDL-C as target in a population composed of high cardiac risk patients.MethodsLipid profile data from patients with TG ≤ 4.52 mmol/L (<400 mg/dl) were used. The high cardiac risk group (N 4150) consisted of patients over 40 years of age that had an A1C level of 6.5% or above and patients with a history of atherosclerotic cardiovascular disease (ASCVD). Comparisons were made between the Martin/Hopkins formula (MH-LDL-C), the Friedewald formula (F-LDL-C), Non-HDL-C and ApoB.ResultsHigher LDL-C values (0.15 mmol/L or 7.3%) were obtained using MH-LDL-C compared to the F-LDL-C. The % within target (%WT) values for F-LDL-C, MH-LDL-C, Non-HDL-C and ApoB were similar when TG levels were ≤ 1.5 mmol/L with a high degree of concordance as measured by the kappa statistic. When compared to F-LDL-C, Non-HDL-C and ApoB showed a profound decrease in the WT value as TG levels increased from normal (67.7%) to intermediate (39.1%) and high levels (20.8%). MH-LDL-C showed an attenuated decrease in the WT value as TG increased from normal (61.4%) intermediate (43.4%) and high levels (32.7%). Concordance with the alternate target parameters was higher for MH-LDL-C than for F-LDL-C when triglycerides levels were increased.ConclusionThe Martin/Hopkins modified equation for estimating LDL-C is a significant improvement on the decade’s old Friedewald formula; however it remains an imperfect tool to estimate the atherogenic load in patients with high TG levels. |
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| Keywords: | Lipid profile Diabetes Martin/Hopkins equation Estimation of LDL-C |
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