CARDIOVASCULAR JOURNAL OF AFRICA • Volume 35, No 2, May – August 2024 AFRICA 105 going lower extremity revascularization. Vasc Med 2020; 25(6): 527–533. 4. Beckman JA, Schneider PA, Conte MS. Advances in revascularization for peripheral artery disease: revascularization in PAD. Circ Res 2021; 128(12): 1885–1912. 5. Beckman JA, Schneider PA, Conte MS. Advances in revascularization for peripheral artery disease: revascularization in PAD. Circ Res 2021; 128(12): 1885–1912.. 6. Giannopoulos S, Armstrong EJ. Dual antiplatelet therapy after endovascular revascularization of infrainguinal arteries. Vasc Med 2019; 24(6): 536–538. 7. Rijkse E, Kimenai HJAN, Roodnat JI, Ten RASA S, Bijdev AS, Ate DC, van Dam JL, et al. Impact of aortoiliac stenosis on graft and patient survival in kidney transplant recipients using the TASC II classification. Transplantation 2019; 103(10): 2164–2172. 8. Cho S, Lee YJ, Ko YG, Kang TS, Lim SH, Hong SJ, et al. 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Management of peripheral arterial interventions with mono or dual antiplatelet therapy –the MIRROR study: a randomised and doubleblinded clinical trial. Eur Radiol 2012; 22: 1998–2006. 20. Nagelschmitz J, Blunck M, Kraetzschmar J, Ludwig M, Wensing G, Hohlfeld T. Pharmacokinetics and pharmacodynamics of acetylsalicylic acid after intravenous and oral administration to healthy volunteers. Clin Pharmacol 2014; 6: 51–59. 21. Karaźniewicz-Łada M, Danielak D, Burchardt P, Kruszyna L, Komosa A, Lesiak M, et al. Clinical pharmacokinetics of clopidogrel and its metabolites in patients with cardiovascular diseases. Clin Pharmacokinet 2014; 53(2): 155–164. … continued from page 101 The Friedewald equation rated badly compared with the direct LDL-C assay in an out-patient cohort, misclassifying 12% of all patients across different LDL-C cut-off points. Dissatisfaction with the performance of the equation has led to the development of newer equations, two of which have been found to be robust and accurate: the Martin–Hopkins equation and the Sampson–NIH equation samples. These both performed better than the Friedewald equation in recent SA cohorts, including diabetics and children. The newer equation published by Sampson et al. improves accuracy with low LDL-C and hypertriglyceridaemia samples, as these are problematic with the Friedewald equation. The NHLS committee has implemented the Sampson-NIH2 equation to modernise practice and report more accurate patient results because the superiority of the newer equations is undeniable. They suggest private-sector labs and clinicians adopt one of the newer options. The Martin–Hopkins equation shows excellent comparability with a direct assay, as demonstrated extensively internationally and locally. The Sampson-NIH and extended Martin-Hopkins demonstrate favourable comparability with direct LDL-C with triglyceride levels up to 9 mmol/l, but this still warrants further investigation in SA cohorts. Reducing the need for direct LDL-C assays will reduce the overall cost of a lipid profile and lower lab expenditure. The Friedewald equation is no longer fit for purpose, and laboratories should switch to one of the newer equations. Source: MedicalBrief 2024
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