Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

LDL-C Assessment of Secondary Non-HDL-C & ApoB Targets

Circulation; ePub 2018 Mar 5; Sathiyakumar, et al

Guideline-suggested non-HLD-C targets may alter management in only a small fraction of individuals, including those with coronary disease and other high-risk clinical features, a recent study concluded after more accurately estimating low-density lipoprotein cholesterol (LDL-C) in a large US population. Researchers analyzed 2,518 adults from the 2011-2012 National Health and Nutrition Examination Survey and 126,092 patients from the Very Large Database of Lipids study with apolipoprotein B (apoB). They found:

  • A total of 7-9% and 31-36% of individuals had LDL-C <70 and <100 mg/dL, respectively.
  • Among those with LDL-CF <100 mg/dL (Friedewald estimation), 8-10% had non-HDL-C ≥130 mg/dL and 2-3% had apoB ≥100 mg/dL.
  • By comparison, among those with LDL-CN <70 or 100 mg/dL (novel method), only ~2% and ~1% of individuals, respectively, had non-HDL-C and apoB values above guideline targets.
  • Similar trends were observed among those with high-risk clinical features.


Sathiyakumar V, Park J, Quispe R, et al. Impact of novel LDL-C assessment on the utility of secondary non-HDL-C and ApoB targets in selected worldwide dyslipidemia guidelines. [Published online ahead of print March 5, 2018]. Circulation. doi:10.1161/CIRCULATIONAHA.117.032463.