Journal article
Assessing the Accuracy of Estimated Lipoprotein(a) Cholesterol and Lipoprotein(a)‐Free Low‐Density Lipoprotein Cholesterol
Journal of the American Heart Association, v 11(2), pp e023136-e023136
18 Jan 2022
PMID: 35023348
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background
Accurate measurement of the cholesterol within lipoprotein(a) (Lp[a]‐C) and its contribution to low‐density lipoprotein cholesterol (LDL‐C) has important implications for risk assessment, diagnosis, and treatment of atherosclerotic cardiovascular disease, as well as in familial hypercholesterolemia. A method for estimating Lp(a)‐C from particle number using fixed conversion factors has been proposed (Lp[a]‐C from particle number divided by 2.4 for Lp(a) mass, multiplied by 30% for Lp[a]‐C). The accuracy of this method, which theoretically can isolate “Lp(a)‐free LDL‐C,” has not been validated.
Methods and Results
In 177 875 patients from the VLDbL (Very Large Database of Lipids), we compared estimated Lp(a)‐C and Lp(a)‐free LDL‐C with measured values and quantified absolute and percent error. We compared findings with an analogous data set from the Mayo Clinic Laboratory. Error in estimated Lp(a)‐C and Lp(a)‐free LDL‐C increased with higher Lp(a)‐C values. Median error for estimated Lp(a)‐C <10 mg/dL was −1.9 mg/dL (interquartile range, −4.0 to 0.2); this error increased linearly, overestimating by +30.8 mg/dL (interquartile range, 26.1–36.5) for estimated Lp(a)‐C ≥50 mg/dL. This error relationship persisted after stratification by overall high‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol subtypes. Similar findings were observed in the Mayo cohort. Absolute error for Lp(a)‐free LDL‐C was +2.4 (interquartile range, −0.6 to 5.3) for Lp(a)‐C<10 mg/dL and −31.8 (interquartile range, −37.8 to −26.5) mg/dL for Lp(a)‐C≥50 mg/dL.
Conclusions
Lp(a)‐C estimations using fixed conversion factors overestimated Lp(a)‐C and subsequently underestimated Lp(a)‐free LDL‐C, especially at clinically relevant Lp(a) values. Application of inaccurate Lp(a)‐C estimations to correct LDL‐C may lead to undertreatment of high‐risk patients.
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Details
- Title
- Assessing the Accuracy of Estimated Lipoprotein(a) Cholesterol and Lipoprotein(a)‐Free Low‐Density Lipoprotein Cholesterol
- Creators
- Weili Zheng - Johns Hopkins MedicineMichael Chilazi - Johns Hopkins MedicineJihwan Park - Bloomberg (United States)Vasanth Sathiyakumar - Johns Hopkins MedicineLeslie J. Donato - Mayo Clinic in ArizonaJeffrey W. Meeusen - Mayo Clinic in ArizonaMariana Lazo - Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MDEliseo Guallar - Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MDKrishnaji R. Kulkarni - VAP Diagnostics Laboratory Birmingham ALAllan S. Jaffe - Mayo Clinic in ArizonaRaul D. Santos - Hospital Israelita Albert EinsteinPeter P. Toth - CGH Medical CenterSteven R. Jones - Johns Hopkins University School of MedicineSeth S. Martin - Johns Hopkins Medicine
- Publication Details
- Journal of the American Heart Association, v 11(2), pp e023136-e023136
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative
- Web of Science ID
- WOS:000743983000028
- Scopus ID
- 2-s2.0-85123281256
- Other Identifier
- 991020550348104721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems