Atherosclerotic cardiovascular disease involves the hardening and narrowing of the arteries due to the buildup of plaques made of cholesterol and fat cells (also known as lipids). In the disease’s later stages, plaques can block arteries, leading to heart attack and/or stroke, which in turn can lead to disability and even death. Thankfully, these outcomes can be prevented through lifestyle modifications, such as changes in diet and exercise, and through cholesterol-lowering medication. Atherosclerosis often doesn’t have symptoms until a severe blockage occurs, making routine lipid testing integral to catching it in time for patients to start treatment. However, lipid tests are not currently standardized, with many testing parameters that could impact a patient’s diagnosis varying from lab to lab. This means that, depending on where a patient is tested, they could get an incorrect test result that leads to them not getting the life-saving treatment they need.

A multidisciplinary group of experts formed by the Academy of Diagnostics & Laboratory Medicine set out to remedy this situation by developing a guidance document that covers all the best practices that labs and healthcare providers should follow when testing for lipids. This guidance draws on the most rigorous, up-to-date research, and key highlights of its recommendations include the following:

  • Standard lipid panels should report total cholesterol, triglycerides, and high-density lipoprotein cholesterol (HDL-C).
  • Non-HDL-C and low-density lipoprotein cholesterol (LDL-C) should be calculated and reported as well using the newer Martin and Sampson equations, which are more accurate than the traditional methods used to calculate these values.
  • Only patients with hypertriglyceridemia and pediatric patients with elevated non-HDL-C need to fast before giving samples for a lipid panel. This will make lipid testing more accessible for patients for whom fasting is difficult, such as older patients and those who are on certain medications.

“The guidance document aims to improve standardization of clinical lipid testing workflows,” wrote the document authors Drs. Jing Cao, Leslie Donato, Joe M. El-Khoury, Anne Goldberg, Jeffery W. Meeusen, and Alan T. Remaley. “It is our hope that these recommendations and subsequent revisions serve as a comprehensive resource to support clinicians and laboratories in lipid assessment and enhancing patient care.”