Dataset Information

Utility of non-HDL-C and apoB targets in the context of new more aggressive lipid guidelines.

ABSTRACT:

Objective

Major guidelines recommend the use of secondary targets, such as non-HDL-C and apoB, to further reduce cardiovascular risk. We aimed to evaluate the proportion at which newer, more aggressive secondary lipid targets are exceeded in patients with LDL-C < 70 mg/dL estimated by Friedewald (LDLf-C) and Martin/Hopkins equations (LDLm-C).

Methods

We analyzed patients from the Very Large Database of Lipids with fasting lipids and estimated LDL-C <70 mg/dL by the Friedewald equation and Martin/Hopkins algorithm. Patients were categorized into three groups: LDL-C <40, 40-54 and 55-69 mg/dL. We calculated the proportion of patients with non-HDL-C and apoB above high-risk targets (non-HDL-C ≥ 100 and apoB ≥ 80mg/dL) for those with LDL-C 55-69 mg/dL and very high-risk targets (non-HDL-C ≥ 85 and apoB ≥ 65mg/dL) for those with LDL-C < 40 mg/dL and 40-54 mg/dL.

Results

In patients with LDLf-C < 40 mg/dL, ~8 and ~4% did not meet high-risk secondary targets and ~21 and 25% did not meet very high-risk secondary targets for non-HDL-C and apoB, respectively. However, in patients with LDLm-C < 40 mg/dL <1% did not meet high-risk targets, while only 3% did not meet the very-high risk secondary target for apoB and none exceeded the very-high risk secondary target for non-HDL-C. Among individuals with LDL-C< 40 mg/dL, there were increasing proportions of individuals not meeting the very high-risk secondary apoB target at greater triglyceride levels, reaching up to ~19% using LDLm-C compared to ~60% using LDLf-C when triglyceride levels were 200-399 mg/dL. There were higher proportions of individuals not meeting high and very-high risk targets as triglyceride levels increased among those with LDL-C 40-54 and 55-69 mg/dL.

Conclusion

In a large, US cross-sectional sample of individuals with LDL-C < 70 mg/dL, secondary non-HDL-C and apoB targets overall provide modest utility. However, attainment of very high-risk cutpoints for non-HDL-C and apoB is not achieved in a significant fraction of patients with triglycerides 200-399 mg/dL, even when using a more accurate calculation of LDL-C.

SUBMITTER: Quispe R

PROVIDER: S-EPMC8387302 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature

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Publications

Utility of non-HDL-C and apoB targets in the context of new more aggressive lipid guidelines.

Quispe Renato R Brownstein Adam J AJ Sathiyakumar Vasanth V Park Jihwan J Chang Blair B Sajja Aparna A Guallar Eliseo E Lazo Mariana M Jones Steven R SR Martin Seth S SS

American journal of preventive cardiology 20210529

<h4>Objective</h4>Major guidelines recommend the use of secondary targets, such as non-HDL-C and apoB, to further reduce cardiovascular risk. We aimed to evaluate the proportion at which newer, more aggressive secondary lipid targets are exceeded in patients with LDL-C < 70 mg/dL estimated by Friedewald (LDLf-C) and Martin/Hopkins equations (LDLm-C).<h4>Methods</h4>We analyzed patients from the Very Large Database of Lipids with fasting lipids and estimated LDL-C <70 mg/dL by the Friedewald equa ...[more]

PMID: 34611642

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Dataset Information

Utility of non-HDL-C and apoB targets in the context of new more aggressive lipid guidelines.

Objective

Methods

Results

Conclusion

Publications

Utility of non-HDL-C and apoB targets in the context of new more aggressive lipid guidelines.

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