Direct LDL is a specialized test that directly measures low-density lipoprotein cholesterol levels without requiring fasting or calculation from other lipid values. This test is particularly valuable for patients with elevated triglycerides (>400 mg/dL) where traditional LDL calculation using the Friedewald formula becomes unreliable. Direct LDL measurement provides accurate assessment of cardiovascular risk in nonfasting patients and those with metabolic disorders that affect triglyceride levels. LDL cholesterol is considered the primary target for cardiovascular risk assessment and treatment according to National Cholesterol Education Program guidelines. This test helps avoid misclassification of patients' cardiovascular risk when traditional lipid calculations are inaccurate, ensuring appropriate treatment decisions for cholesterol management and cardiovascular disease prevention.