Anna Wolska1, Alan T Remaley. 1. Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.
Abstract
PURPOSE OF REVIEW: Cholesterol on low-density lipoproteins (LDL-C) is one of the main drivers of atherosclerotic cardiovascular disease (ASCVD) and hence its measurement is critical in the management of patients at risk. Although LDL-C has routinely been either calculated by the Friedewald equation or measured with direct assays, these methods have limitations, particularly for patients with dyslipidaemias, low LDL-C, and hypertriglyceridemia. The focus of this review will be recent advances in the measurement of LDL for ASCVD risk management. RECENT FINDINGS: We first describe the recent recommendations on how LDL-C is used in ASCVD risk assessment and management. We then review the current approaches to the measurement of LDL-C and recent developments on new more accurate equations for calculating LDL-C. Finally, we present new and emerging LDL assays that may be superior to LDL-C for risk assessment, such as LDL particle number and small dense LDL-C, and several LDL-based lipid tests in early development. SUMMARY: LDL-C is valuable in ASCVD risk management but recent improvements in its measurement and the development of other LDL-related tests may further improve its value.
PURPOSE OF REVIEW: Cholesterol on low-density lipoproteins (LDL-C) is one of the main drivers of atherosclerotic cardiovascular disease (ASCVD) and hence its measurement is critical in the management of patients at risk. Although LDL-C has routinely been either calculated by the Friedewald equation or measured with direct assays, these methods have limitations, particularly for patients with dyslipidaemias, low LDL-C, and hypertriglyceridemia. The focus of this review will be recent advances in the measurement of LDL for ASCVD risk management. RECENT FINDINGS: We first describe the recent recommendations on how LDL-C is used in ASCVD risk assessment and management. We then review the current approaches to the measurement of LDL-C and recent developments on new more accurate equations for calculating LDL-C. Finally, we present new and emerging LDL assays that may be superior to LDL-C for risk assessment, such as LDL particle number and small dense LDL-C, and several LDL-based lipid tests in early development. SUMMARY:LDL-C is valuable in ASCVD risk management but recent improvements in its measurement and the development of other LDL-related tests may further improve its value.
Authors: Diego Lucero; Anna Wolska; Zahra Aligabi; Sarah Turecamo; Alan T Remaley Journal: Endocrinol Metab Clin North Am Date: 2022-07-08 Impact factor: 4.748