New Methods for Calculating LDL-Cholesterol and Related Biomarkers of Atherosclerotic Cardiovascular Disease Risk

This review describes the recently developed equations for calculating Low-density lipoprotein cholesterol (LDL-C), and equations for estimating small dense LDL-cholesterol (sdLDL-C), and LDL-triglycerides (LDL-TG) for atherosclerotic cardiovascular disease (ASCVD) risk assessment. The new Modified Sampson-NIH equation provides a more accurate estimation of LDL-C across a wide range of TG levels compared to the traditional and still commonly used Friedewald equation. Furthermore, it is more accurate compared to other equations at the low LDL-C cutpoints used for high-risk and very high-risk ASCVD patients and is valuable for deciding the need for additional lipid-lowering therapy. New equations for calculating sdLDL-C and LDL-TG use the same lipid parameters as for calculating LDL-C but offer additional insights into atherogenic lipoprotein burden. High plasma TG and very low LDL-C concentrations necessitate more accurate LDL-C calculations, which can be readily adopted without additional cost to improve ASCVD risk management.