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FH patients often have increased lipoprotein(a) [Lp(a)] levels, which further increase CVD risk. Novel methods for accurately calculating LDL-C have been proposed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with FH were recruited by a network of Greek sites participating in the HELLAS-FH registry. LDL-C levels were calculated using the Friedewald (LDL-C<jats:sub>F<\/jats:sub>) and the Martin\/Hopkins (LDL-C<jats:sub>M\/H<\/jats:sub>) equations as well as after correcting LDL-C<jats:sub>M\/H<\/jats:sub>for Lp(a) levels [LDL-C<jats:sub>Lp(a)corM\/H<\/jats:sub>]. The objective was to compare LDL-C levels and target achievement as estimated by different methods in FH patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This analysis included 1620 patients (1423 adults and 197 children). In adults at diagnosis, LDL-C<jats:sub>F<\/jats:sub>and LDL-C<jats:sub>M\/H<\/jats:sub>levels were similar [235\u2009\u00b1\u200970\u2009mg\/dL (6.1\u2009\u00b1\u20091.8\u2009mmol\/L) vs 235\u2009\u00b1\u200969\u2009mg\/dL (6.1\u2009\u00b1\u20091.8\u2009mmol\/L), respectively;<jats:italic>P<\/jats:italic>\u2009=\u2009NS], while LDL-C<jats:sub>Lp(a)corM\/H<\/jats:sub>levels were non-significantly lower than LDL-C<jats:sub>F<\/jats:sub>[211\u2009\u00b1\u200961\u2009mg\/dL (5.5\u2009\u00b1\u20091.6\u2009mmol\/L);<jats:italic>P<\/jats:italic>\u2009=\u20090.432]. In treated adults (<jats:italic>n<\/jats:italic>\u2009=\u2009966) both LDL-C<jats:sub>F<\/jats:sub>[150\u2009\u00b1\u200971\u2009mg\/dL (3.9\u2009\u00b1\u20091.8\u2009mmol\/L)] and LDL-C<jats:sub>M\/H<\/jats:sub>levels [151\u2009\u00b1\u200970\u2009mg\/dL (6.1\u2009\u00b1\u20091.8\u2009mmol\/L);<jats:italic>P<\/jats:italic>\u2009=\u20090.746] were similar, whereas LDL-C<jats:sub>Lp(a)corM\/H<\/jats:sub>levels were significantly lower than LDL-C<jats:sub>F<\/jats:sub>[121\u2009\u00b1\u200962\u2009mg\/dL (3.1\u2009\u00b1\u20091.6\u2009mmol\/L);<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001]. Target achievement as per latest guidelines in treated patients using the LDL-C<jats:sub>M\/H<\/jats:sub>(2.5%) and especially LDL-C<jats:sub>Lp(a)corM\/H<\/jats:sub>methods (10.7%) were significantly different than LDL-C<jats:sub>F<\/jats:sub>(2.9%;<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><jats:p>In children, all 3 formulas resulted in similar LDL-C levels, both at diagnosis and in treated patients. However, target achievement by LDL-C<jats:sub>F<\/jats:sub>was lower compared with LDL-C<jats:sub>M\/H<\/jats:sub>and LDL-C<jats:sub>Lp(a)corM\/H<\/jats:sub>methods (22.1 vs 24.8 vs 33.3%;<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001 for both comparisons).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>LDL-C<jats:sub>Lp(a)corM\/H<\/jats:sub>results in significantly lower values and higher target achievement rate in both treated adults and children. If validated in clinical trials, LDL-C<jats:sub>Lp(a)corM\/H<\/jats:sub>may become the method of choice to more accurately estimate \u2018true\u2019 LDL-C levels in FH patients.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12944-020-01289-5","type":"journal-article","created":{"date-parts":[[2020,5,28]],"date-time":"2020-05-28T14:03:24Z","timestamp":1590674604000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Achieving low-density lipoprotein cholesterol targets as assessed by different methods in patients with familial hypercholesterolemia: an analysis from the HELLAS-FH registry"],"prefix":"10.1186","volume":"19","author":[{"given":"Christos V.","family":"Rizos","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matilda","family":"Florentin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis","family":"Skoumas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Tziomalos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loukianos","family":"Rallidis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasileios","family":"Kotsis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasileios","family":"Athyros","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanouil","family":"Skalidis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genovefa","family":"Kolovou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasia","family":"Garoufi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleni","family":"Bilianou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iosif","family":"Koutagiar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Agapakis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Estela","family":"Kiouri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Antza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niki","family":"Katsiki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evangelos","family":"Zacharis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Achilleas","family":"Attilakos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Sfikas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panagiotis","family":"Anagnostis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8583-153X","authenticated-orcid":false,"given":"Demosthenes B.","family":"Panagiotakos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evangelos N.","family":"Liberopoulos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,5,28]]},"reference":[{"key":"1289_CR1","doi-asserted-by":"publisher","first-page":"3478","DOI":"10.1093\/eurheartj\/eht273","volume":"34","author":"BG Nordestgaard","year":"2013","unstructured":"Nordestgaard BG, Chapman MJ, Humphries SE, Ginsberg HN, Masana L, Descamps OS, Wiklund O, Hegele RA, Raal FJ, Defesche JC, et al. 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For patients aged 6\u201318\u2009years the patient informed assent of the minor as well as the informed consent of their parents\/guardians was required.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"CVR, MF, KT, VK, AG, IK, DA, EK, CA, AA, GS, PA and DBP have no relevant conflict of interest to report. IS has received research grants and honoraria from Amgen, Sanofi, MSD and Elpen. LR has received honoraria for lectures, clinical trials and consultant fees from Amgen, MSD, MYLAN, Servier, AstraZeneca and Sanofi-Aventis. VA has an association with the pharmaceutical companies Amgen, Sanofi-Aventis, Servier and Lilly. ES has participated in educational and advisory activities sponsored by AstraZeneca, Medtronic, MSD, Sanofi and Servier. GK has given talks, attended conferences and participated in trials sponsored by Amgen, Angelini, MSD, Lilly, Vianex and Sanofi and has also accepted travel support to conferences from Amgen, Sanofi and MSD. EB has given talks, attended conferences and participated in trials sponsored by Amgen, Angelini, Lilly, MSD, Sanofi-Aventis and Vianex and has also accepted travel support to conferences from Amgen, MSD, Pfizer and Sanofi. NK has given talks, attended conferences and participated in trials sponsored by Amgen, Astra Zeneca, Boehringer Ingelheim, Elpen, Mylan, NovoNordisk, PharmaSwiss, Sanofi, Servier and WinMedica. EZ has received honoraria for lectures from Amgen. Sanofi, MSD, and Astra Zeneca. ENL has participated in educational, research and advisory activities sponsored by AstraZeneca, MSD, Lilly, Bayer, Amgen, Sanofi, Boehringer-Ingelheim, Novartis, Novo Nordisk, Valeant and Servier.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"114"}}