Limitations of a Cardiac Risk (QRISK2) Calculator in Patients with High Density Lipoprotein (HDL).

Introduction: There is existing debate as to the relationship between blood concentration of HDL (high density lipoprotein) and cardiovascular outcomes. Patients with hyperalphalipoproteinaemia (HALP) have high HDL levels and this can be attributed to a variety of factors.

Aim And Methods: This study aims for the first time to examine the HALP cohort and understand demographics, relationship with cardiovascular disease (CVD) risk and scoring with a cardiac risk calculator (QRISK 2 calculator).

Results: The study found 42 patients had a statistically significant difference (p = 0.001) between CVD risk estimated using actual measured HDL (Score 1) versus CVD risk calculated using standard population mean HDL values (Score 2). Furthermore, in the CVD event group (n = 6) a significant difference was also seen between Score 1 and Score 2 (p = 0.027).

Conclusion: The study highlights issues with underestimation of CVD risk in this population and strongly advocates use of standard population mean values in assessment of CVD risk.