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

## TL;DR

New equations for calculating LDL cholesterol improve accuracy in assessing heart disease risk, especially in patients with high triglycerides or very low LDL levels.

## Contribution

The development of the Modified Sampson-NIH equation and new methods for sdLDL-C and LDL-TG estimation.

## Key findings

- The Modified Sampson-NIH equation is more accurate than the Friedewald equation for LDL-C estimation across various TG levels.
- New equations for sdLDL-C and LDL-TG provide additional insights into atherogenic lipoprotein burden using the same lipid parameters.
- Improved LDL-C calculations can enhance ASCVD risk management without additional costs.

## Abstract

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.