{
  "abstract": "AIM: Recent evidence reports good agreement between measured and estimated small-dense low-density lipoprotein cholesterol (EsdLDL-C) using a readily applicable formula. Its clinical utility in heterozygous familial hypercholesterolemia (HeFH) has not yet been evaluated. We aimed to evaluate the sex-specific associations of pre-treatment EsdLDL-C with coronary artery disease (CAD) prevalence in adult patients with HeFH and its discriminative value beyond LDL-C. METHODS: Data from consecutively recruited adults with a clinical diagnosis of HeFH from an ongoing registry (HELLAS-FH, n = 3,276) were analyzed. Patient demographics, lipid parameters, CAD risk factors, and CAD prevalence at registry enrollment were evaluated. EsdLDL-C was calculated at pre-treatment (i.e., before any hypolipidemic therapy initiation) using the Sampson equation. RESULTS: EsdLDL-C was associated with an increased prevalence of type 2 diabetes and hypertension, a higher body mass index and triglycerides, and lower high-density lipoprotein cholesterol. EsdLDL-C was also the strongest independent lipid-associated factor for CAD (OR: 1.24, p＜0.001). This association was more pronounced in women (OR 1.57, p＜0.001). EsdLDL-C showed higher CAD discrimination than LDL-C (AUC 0.611 vs. 0.522). Incorporating EsdLDL-C into the best discriminative model improved discriminative ability vs the core model (AUC 0.831 vs 0.828, p = 0.038) and overall model fit (ΔAIC) = -10.3). This incremental predictive value was driven predominantly by females (ΔAIC = -14.1; AUC 0.787 vs 0.769, p = 0.015). CONCLUSION: In a large sample of patients with clinical HeFH, EsdLDL-C was incrementally associated with CAD beyond LDL-C. This finding was more pronounced in women. The clinical utility of this readily available lipid marker as a risk enhancer should therefore be further investigated.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 41,
  "authors": [
    {
      "name": "Dimitrios Delialis"
    },
    {
      "name": "Christos V. Rizos"
    },
    {
      "name": "Evmorfia Aivalioti"
    },
    {
      "name": "Chrysoula Moustou"
    },
    {
      "name": "George Liamis"
    },
    {
      "name": "Ioannis Skoumas"
    },
    {
      "name": "George Sfikas"
    },
    {
      "name": "Genovefa Kolovou"
    },
    {
      "name": "Loukianos Rallidis"
    },
    {
      "name": "Anastasia Garoufi"
    },
    {
      "name": "Konstantinos Tziomalos"
    },
    {
      "name": "Emmanouil Skalidis"
    },
    {
      "name": "Vasileios Kotsis"
    },
    {
      "name": "Evgenia Mavrokefalou"
    },
    {
      "name": "Michalis Doumas"
    },
    {
      "name": "Vaia Lambadiari"
    },
    {
      "name": "Panagiotis Anagnostis"
    },
    {
      "name": "Theodosios Filippatos"
    },
    {
      "name": "Amalia Boufidou"
    },
    {
      "name": "Vasiliki Giannakopoulou"
    },
    {
      "name": "Georgia Anastasiou"
    },
    {
      "name": "Spyridon Spantidakis"
    },
    {
      "name": "Charalambos Vlachopoulos"
    },
    {
      "name": "Ioanna Dima"
    },
    {
      "name": "Charalambos Koumaras"
    },
    {
      "name": "Elisavet Prodromiadou"
    },
    {
      "name": "Vana Kolovou"
    },
    {
      "name": "Georgios Fakas"
    },
    {
      "name": "Konstantinos A. Papathanasiou"
    },
    {
      "name": "Achilleas Attilakos"
    },
    {
      "name": "Dimitrios Agapakis"
    },
    {
      "name": "Evangelos Zacharis"
    },
    {
      "name": "Christina Antza"
    },
    {
      "name": "Aspasia Antonopoulou"
    },
    {
      "name": "Chrysoula Boutari"
    },
    {
      "name": "Aikaterini Kountouri"
    },
    {
      "name": "Maria Pappa"
    },
    {
      "name": "Evangelia Koukou"
    },
    {
      "name": "Eleni Mpellou"
    },
    {
      "name": "Evangelos Liberopoulos"
    },
    {
      "name": "Kimon Stamatelopoulos"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/26g2r9enq2pb2.bib",
  "cited_by": 0,
  "doi": "10.5551/jat.66409",
  "fulltext_url": "https://www.jstage.jst.go.jp/article/jat/advpub/0/advpub_66409/_article",
  "id": "26g2r9enq2pb2",
  "issns": [
    "1880-3873",
    "1340-3478"
  ],
  "landing_url": "https://www.jstage.jst.go.jp/article/jat/advpub/0/advpub_66409/_article",
  "language": null,
  "licence": "CC-BY-NC-SA",
  "licence_label": "CC BY-NC-SA",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-sa/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "jstage-journal",
      "medicine/cardiovascular"
    ],
    [
      "openalex",
      "2746|Lipoproteins and Cardiovascular Health"
    ]
  ],
  "openalex": "W7223293250",
  "pdf_url": "https://www.jstage.jst.go.jp/article/jat/advpub/0/advpub_66409/_pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-24",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/26g2r9enq2pb2.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:22Z",
      "native_id": "10.5551/jat.66409",
      "source": "jstage",
      "url": "https://www.jstage.jst.go.jp/article/jat/advpub/0/advpub_66409/_article"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Lipoproteins and Cardiovascular Health",
      "subfield": "surgery"
    }
  ],
  "title": "Estimated Small Dense LDL Cholesterol and Coronary Artery Disease in Familial Hypercholesterolemia",
  "title_text": "Estimated Small Dense LDL Cholesterol and Coronary Artery Disease in Familial Hypercholesterolemia",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:22Z",
  "url": "https://research.draconitic.com/paper/26g2r9enq2pb2",
  "venue": "Journal of Atherosclerosis and Thrombosis",
  "versions": []
}