Findings Suggest Lipid Assessment in Vascular Disease Can Be Simplified, Without the Need to Fast
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Lipid assessment in vascular disease can be simplified by measuring either (1) total cholesterol and high-density lipoprotein cholesterol (HDL-C) or (2) apolipoproteins, without the need to fast and without regard to triglyceride levels, according to a study published in the November 11, 2009, issue of JAMA.
The study—which was based on data from the Emerging Risk Factors Collaboration—included individual records for 302,430 participants in 68 long-term prospective studies, mostly in Europe and North America. During the follow-up periods (representing 2.79 million person-years), there were 8,857 nonfatal myocardial infarctions, 3,928 deaths from coronary heart disease, 2,534 ischemic strokes, 513 hemorrhagic strokes and 2,536 unclassified stokes.
The authors derived their conclusion from several findings:
• Hazard ratios with non-high-density lipoprotein cholesterol (non-HDL-C) and HDL-C were nearly identical to those seen with apo B and apo AI.
• Hazard ratios for vascular disease with lipid levels were at least as strong in participants who did not fast as in those who fasted.
• Hazard ratios were similar with non–HDL-C as with directly measured LDL-C.
• Triglyceride concentration was not independently related with coronary heart disease risk after controlling for HDL-C, non–HDL-C, and other standard risk factors.
JAMA. 2009; 302(18):1993-2000.