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
- Although the US cholesterol management guidelines support nonfasting lipid measures, clinicians may still prefer fasting levels, viewing them as more accurate.
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.
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