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

Abstract

Several formulas have been developed to estimate the LDL-C values, such as the Friedewald, Martin-Hopkins, Sampson, and Anandaraja equations. However, their performance has not been extensively evaluated. Therefore, this study aimed to evaluate the agreement of these LDL-C formulas and analyze the clinical LDL-C group reclassification. The results showed that Friedewald consistently underestimates LDL-C compared to the 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.