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A modification of Friedewald’s formula to estimate serum low-density lipoprotein cholesterol (LDLC) up to serum triglyceride (TG) level of 11.3 mmol/L in Bangladeshi population has recently been published. The aim of this study was to compare the modified formula with direct measurement of LDLC in Bangladeshi population in a different setting. One thousand and fifty two specimens from adult subjects were analyzed. Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), LDLC and TG were measured by standard methods. The modified Friedewald’s formula was applied to estimate LDL cholesterol concentration. Results were expressed as mean ± SD and calculated LDLC was compared with measured LDLC by two-tailed paired t test, Bland-Altman plot for absolute bias, Pearson’s correlation coefficients of calculated LDLC with measured LDLC and Passing & Bablok regression equation of calculated LDLC against measured LDLC. The mean ± SD of measured LDLC was 2.98±0.82 mmol/L. LDLC calculated by modified Friedewald’s formula was 2.77±0.86 mmol/L. The mean absolute bias was –0.20±0.32 mmol/L, Pearson’s correlation coefficient (r) was 0.9293 (P<0.0001) and Passing & Bablok regression equation was y= – 0.3856+1.0597x for modified formula up to serum TG?11.3 mmol/L. Compared to original Friedewald’s formula, performance of the modified Friedewald’s formula was better up to serum TG?4.52 mmol/L. The study reveals that the modified Friedewald’s formula may be used to calculate LDLC approximately in Bangladeshi population. DOI: http://dx.doi.org/10.3329/bmrcb.v39i3.20312 Bangladesh Med Res Counc Bull 2013; 39: 120-123

BACKGROUND: Clinical trials have shown that the use of lipid-lowering agents in postmyocardial infarction (MI) patients reduces rates of subsequent coronary events, reduces coronary artery bypass surgery rates, and improves survival. Physician decisions to prescribe lipid-lowering drugs is influenced by a number of patient factors, including age, medical history, and serum cholesterol levels. The purpose of this study was to examine physician behaviors in prescribing lipid-lowering therapy in patients after acute MI. METHODS AND RESULTS: A retrospective study was conducted at a local community-based hospital. A total of 129 patients with validated acute MI, hospitalized between January 1996 and December 1996, was included in the study sample. Variables abstracted included patient age, sex, race, primary diagnosis, medical history, lipid-lowering interventions of the discharge plan, and other discharge instructions regarding smoking cessation, activity, and dietary modification. Descriptive analysis was performed. The study showed that only 7 subjects (8.8%) were discharged on lipid-lowering drugs. Several patients who did not undergo therapy had either a low-density lipoprotein concentration of <130 (n = 13), a high-density lipoprotein concentration of >50 (n = 6), or were on hormone replacement therapy (n = 3). Dietary modification was advised in 100% of subjects (n = 54) for whom the data were included in the charts. CONCLUSIONS: The results of this descriptive study suggests that lipid-lowering drugs are being utilized at low rates in the secondary prevention of acute MI. However, additional risk-lowering factors may play a role in the decision to discharge without drugs. Because of potential side effects associated with their use, a prudent path appears to be the norm in prescription of lipid-lowering drug therapy for MI patients.