More accurate LDL-C calculation: Externally validated, guideline endorsed

Low density lipoprotein-cholesterol (LDL-C) serves as the primary target of therapy for preventing atherosclerotic cardiovascular disease (ASCVD). Recently released European and American guidelines on lipid management recommend attaining very low LDL-C levels (<1.8 mmol/L or even lower) in high and very-high risk patients. Therefore, utilizing an accurate means for determining LDL-C, especially at such low values, is of paramount importance to inform the best clinical decisions and use of effective therapies. This review compares the different methods of determining LDL-C, including the various forms of direct measurement and most commonly used calculations. This review discusses the evidence behind these methods in different populations of patients and in the fasting versus non-fasting state. The Martin/Hopkins method is the preferred method for determining LDL-C as it is the most accurate and widely applicable method. It is especially useful in patients with low LDL-C levels < 1.8 mmol/L (<70 mg/dL) and high triglyceride levels between 1.7 and 4.5 mmol/L (150–399 mg/dL), and is reliable in the non-fasting state.