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- Title
Friedwald's Calculation; Is It Reliable in Estimating Risk of Coronary Heart Disease?
- Authors
Biswas, Shubho S.; Jain, Vaishali; Gokhale, Prerna V.; Agrawal, Vandana
- Abstract
Background and Objectives: Accurate determination of LDL-C is important for the identification and management of patients at risk of CHD. The limitations of the Friedwald's equation led to the expensive direct homogenous assays and an interest in non-HDL-C as markers of risk of CHD, particularly in patients with elevated triglycerides. There are conflicting reports on whether the Friedwald's underestimates LDL-C in comparison to direct, so this study compared the two methods in 800 out patients. Also, comparison of CHD risk detection was done by LDL-C direct, LDL-C calculated and non-HDL-C. Methods and Results: LDL-C by direct method was significantly higher than calculated (mean difference 7.75 mg/dl) and the difference was progressively higher across all categories of TG and TC. The Friedwald's calculation underestimated 570 (71.25%) compared to direct method. Using NCEP risk categorization for LDL-C (<130mg/dl low risk) and non-HDL-C risk categorization of 30mg/dl above that of LDL-C, those at higher risk of CHD numbered 320 (40%) by the direct, 270(33.75%) by non-HDL-C and 220(27.5%) by the calculated method. Overall, 660 (82.5%) out of 800 were similarly classified by all three methods. Conclusion: Although the Friedwald's calculation performs reasonably well, it underestimates LDL-C compared to direct method. It misses identifying a significant number of patients at risk of CHD by direct LDL-C and by non-HDL-C.
- Subjects
CORONARY heart disease risk factors; LOW density lipoproteins; HEALTH risk assessment
- Publication
National Journal of Integrated Research in Medicine, 2017, Vol 8, Issue 4, p27
- ISSN
2230-9969
- Publication type
Article