Yes, nonfasting lipid measurements are really OK

  • Mora S & al.
  • JAMA Intern Med
  • 28 May 2019

  • International Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Nonfasting lipid measurements are similar to fasting measurements in their association with atherosclerotic cardiovascular disease (ASCVD) events.
  • These findings suggest that routinely measuring lipids, fasting or not, can be a handy clinical tool for ASCVD screening and treatment.

Why this matters

Key results

  • Nonfasting results were quite similar to fasting results for cholesterol but had slightly higher triglyceride levels, as would be expected.
  • Classification concordance for ASCVD risk was 94.8%.
  • Associations with ASCVD-related events were similar between fasting and nonfasting measures.
  • Adjusted HRs (95% CIs) for each 40 mg/dL of low-density lipoprotein cholesterol:
    • Fasting: 1.28 (1.07-1.55; P=.008).
    • Nonfasting: 1.32 (1.08-1.61; P=.007).
  • For primary prevention group only:
    • Fasting: 1.37 (1.11-1.69; P=.003).
    • Nonfasting: 1.42 (1.13-1.78; P=.003).
  • No interaction by sex found.

Study design

  • Post hoc, prospective follow-up of a randomized clinical trial of 8270 participants in the Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm (ASCOT-LLA). 
  • Data from February 1, 1998-December 31, 2002.
  • Outcome: major coronary, ASCVD events.
  • This trial ended prematurely after treatment (atorvastatin calcium; Lipitor) showed significant risk reduction.
  • Funding: Pfizer; NIH, others.

Limitations

  • Trial inclusion criteria might preclude generalizability.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit