Laboratory assessment of serum lipid and lipoprotein levels is essential for the management of the risk of atherothrombotic cardiovascular disease (CVD). Traditionally, this has involved the measurement of fasting levels of total and HDL cholesterol, as well as calculation or direct measurement of LDL cholesterol (LDL-C). Contemporaneous fasting triglyceride levels are required for calculation of LDL-C.

Several recent developments have created uncertainty concerning the current and future use of LDL-C as the main focus of CVD management. This presentation will examine the clinical and therapeutic insights that have prompted a reduction in the emphasis on LDL-C. It will also explore alternatives that may enhance laboratory CVD risk assessment, some of which are relatively simple.