Comparison and Agreement of LDL-C Formulas in Cardiovascular Risk Stratification among Malaysia

Abstract

The Friedewald equation is the most applied method for estimating LDL-C values, while newer formulas such as Sampson, Martin–Hopkins, and Anandaraja have been developed to improve accuracy; however, their performance has not been extensively evaluated. This study addresses the current lack of evidence in the Malaysian population. Analysis revealed that Friedewald consistently underestimates LDL-C compared to others, but reclassification using Martin or Sampson may not align with Friedewald-based risk categorization. Anandaraja showed the highest misclassification. These discrepancies may affect treatment decisions. Future studies should validate performance in high-risk subgroups and consider formula-specific cut-offs to improve cardiovascular risk assessment.