The Martin/Hopkins method of LDL-C estimation provided values closer to the gold standard of estimation than the Friedewald estimation method in patients achieving lower LDL-C with PCSK9 inhibition, results of a new analysis of FOURIER patients revealed (which included 27,564 patients with stable atherosclerotic cardiovascular disease). The analysis, published recently in JAMA Cardiology, looked at LDL-C levels obtained in the trial as calculated by the Friedewald method and the Martin/Hopkins method, with the gold standard of preparative ultracentrifugation (PUC) used as a reference.
What is the accuracy of low-density lipoprotein #cholesterol (LDL-C) by Martin/Hopkins vs Friedewald estimation in patients achieving low LDL-C? Find out from @SethShayMartin https://t.co/t330Pwtz7j pic.twitter.com/XS8MQGXSZF
— JAMA Cardiology (@JAMACardio) June 13, 2018
Fourier Study Results
According to the results of the analysis, 22.9% of the LDL-C values calculated via Martin/Hopkins method were greater than 5 mg/dL of the PUC gold standard, with 2.6% varying by more than 10 mg/dL. This was less than those values obtained by the Friedewald method (40.1% and 13.3% respectively). The Friedewald method, the researchers concluded, tended to underestimate LDL-C level compared with the gold standard, resulting in possible undertreatment.
“These data suggest that Martin/Hopkins estimation should be the preferred method to estimate LDL-C levels in such intensively treated patients,” they authors write. More reaction below:
What is the accuracy of low-density lipoprotein #cholesterol (LDL-C) by Martin/Hopkins vs Friedewald estimation in patients achieving low LDL-C? Find out from @SethShayMartin https://t.co/t330Pwtz7j pic.twitter.com/XS8MQGXSZF
— JAMA Cardiology (@JAMACardio) June 13, 2018
In pts achieving low LDL-C w/PCSK9 inhibition, Martin/Hopkins method for LDL-C more closely approximates gold standard preparative ultracentrifugation than Friedewald. Martin/Hopkins may prevent undertreatment because of LDL-C underestimation by Friedewald https://t.co/ThHtdmvM6q
— rodolfo catanho (@rocatanho) June 17, 2018
We do direct LDL @ThePLC but this is seminal work showing the fallacy and false sense of calculated LDL by the majority of labs in the US. Optimizing LDL therapy with a true measurement is key to reducing CV risk https://t.co/8WLWLB8Olp
— Dr. John A Rumberger, PhD, MD, FACC, MSCCT (@DrRumberger) June 14, 2018
Source: JAMA Cardiology
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