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Friedwald’s Calculation; Is It Reliable in Estimating Risk of Coronary Heart Disease?

Shubho S Biswas*, Vaishali Jain**, Prerna V Gokhale***, Vandana Agrawal****.

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. [Biswas S NJIRM 2017; 8(4):27-31]

Key words: Friedwald’s calculation, direct method, non-HDL-C


 
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How to Cite this Article
Pubmed Style

Biswas SS, Jain V, Gokhale PV, Agrawal V. Friedwald’s Calculation; Is It Reliable in Estimating Risk of Coronary Heart Disease?. NJIRM. 2017; 8(4): 27-31.


Web Style

Biswas SS, Jain V, Gokhale PV, Agrawal V. Friedwald’s Calculation; Is It Reliable in Estimating Risk of Coronary Heart Disease?. http://www.nicpdjournals.com/?mno=277384 [Access: December 12, 2017].


AMA (American Medical Association) Style

Biswas SS, Jain V, Gokhale PV, Agrawal V. Friedwald’s Calculation; Is It Reliable in Estimating Risk of Coronary Heart Disease?. NJIRM. 2017; 8(4): 27-31.



Vancouver/ICMJE Style

Biswas SS, Jain V, Gokhale PV, Agrawal V. Friedwald’s Calculation; Is It Reliable in Estimating Risk of Coronary Heart Disease?. NJIRM. (2017), [cited December 12, 2017]; 8(4): 27-31.



Harvard Style

Biswas, S. S., Jain, V., Gokhale, P. V. & Agrawal, V. (2017) Friedwald’s Calculation; Is It Reliable in Estimating Risk of Coronary Heart Disease?. NJIRM, 8 (4), 27-31.



Turabian Style

Biswas, Shubho S, Vaishali Jain, Prerna V Gokhale, and Vandana Agrawal. 2017. Friedwald’s Calculation; Is It Reliable in Estimating Risk of Coronary Heart Disease?. National Journal of Integrated Research in Medicine, 8 (4), 27-31.



Chicago Style

Biswas, Shubho S, Vaishali Jain, Prerna V Gokhale, and Vandana Agrawal. "Friedwald’s Calculation; Is It Reliable in Estimating Risk of Coronary Heart Disease?." National Journal of Integrated Research in Medicine 8 (2017), 27-31.



MLA (The Modern Language Association) Style

Biswas, Shubho S, Vaishali Jain, Prerna V Gokhale, and Vandana Agrawal. "Friedwald’s Calculation; Is It Reliable in Estimating Risk of Coronary Heart Disease?." National Journal of Integrated Research in Medicine 8.4 (2017), 27-31. Print.



APA (American Psychological Association) Style

Biswas, S. S., Jain, V., Gokhale, P. V. & Agrawal, V. (2017) Friedwald’s Calculation; Is It Reliable in Estimating Risk of Coronary Heart Disease?. National Journal of Integrated Research in Medicine, 8 (4), 27-31.



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