Low density lipoprotein classification

Jump to: navigation, search

Low Density Lipoprotein Microchapters

Home

Patient information

Overview

Historical Perspective

Classification

Physiology

Pathophysiology

Causes

Low LDL
High LDL

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Prognosis and Complications

Diagnosis

Laboratory Findings

Treatment

Medical Therapy

Landmark Trials

Future or Investigational Therapies

Case Studies

Case #1

Low density lipoprotein classification On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Low density lipoprotein classification

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Low density lipoprotein classification

CDC on Low density lipoprotein classification

Low density lipoprotein classification in the news

Blogs on Low density lipoprotein classification

Directions to Hospitals Treating Low density lipoprotein

Risk calculators and risk factors for Low density lipoprotein classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]

Overview

Prior approaches to the management of LDL aimed towards the classification of LDL concentrations and the treatment of subjects with dyslipidemia to a target LDL concentration. In 2001, the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III classified LDL concentrations into optimal, near optimal, borderline high, high, and very high.[1] However, the latest 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults no longer takes into consideration LDL cut-off concentration but rather identifies groups of patients among whom the benefit of statin outweighs the risk of adverse events.[2]

Classification

Classification of the Different Concentrations of LDL

Shown below is the classification of the different concentrations of LDL according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III published in 2001.[1]

Concentration mg/dL Concentration mmol/L Interpretation
<100 <2.6 Optimal
100 to 129 2.6 to 3.3 Near optimal
130 to 159 3.3 to 4.1 Borderline high
160 to 189 4.1 to 4.9 High
>190 >4.9 Very high

Classification of Statin Benefit Groups

The 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults no longer takes into consideration LDL cut-off concentration but rather identifies groups of patients among whom the benefit of statin outweighs the risk of adverse events. Shown below is the classification of the four statin benefit groups.[2]

Statin benefit groups
1- Presence of atherosclerotic cardiovascular disease, defined as prior acute coronary syndrome, stable or unstable angina, coronary revascularization, non coronary arterial revascularization, stroke, transient ischemic attack, or peripheral artery disease
2- LDL ≥ 190 mg/dL
3- Diabetes mellitus PLUS age 40-75 years PLUS LDL 10-189 mg/dL
4- LDL 70-189 PLUS estimated 10 year risk of atherosclerotic cardiovascular disease ≥ 7.5%

The estimated 10 year risk of atherosclerotic cardiovascular disease should be calculated every 4 to 6 years using the pooled cohort equation.[2]

References

  1. 1.0 1.1 Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001). "Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III).". JAMA. 285 (19): 2486–97. PMID 11368702. 
  2. 2.0 2.1 2.2 Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH; et al. (2014). "2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.". J Am Coll Cardiol. 63 (25 Pt B): 2889–934. PMID 24239923. doi:10.1016/j.jacc.2013.11.002. 

Linked-in.jpg