OnMedica – News – New study suggests fasting before cholesterol test is useless

Fasting and fasting lipid levels in the same individuals predicted a similar risk of cardiovascular events

A new study * added weight to the growing body of evidence that it is not necessary for most patients to fast before having blood tests to test lipid levels to determine the risk of events. future cardiovascular

Many studies have suggested that fasting before a complete cholesterol test may have little importance in badessing the risk of heart attack, stroke, or other cardiovascular event, but most have been conducted by comparing groups of people at the population level rather than within the population. same individuals. This left a lingering question about the ability of non-fasting lipid levels to predict future events for specific patients.

Now, a large study published in JAMA Internal Medicine provides strong evidence that fasting lipid levels were similar to fasting lipid levels in the same individuals, predicting cardiovascular risk just as well.

Researchers from Imperial College London, Brigham and Women's Hospital and Harvard Medical School in the United States led Prospective one-off prospective study of participants in the Lipid Lowering Test Group (ASCOT-LLA) at Anglo-Scandinavian Cardiac Outcomes (ASCOT-LLA).

Fasting and fasting lipid levels in more than 8,000 participants were measured at four weeks apart without intervention between patients. Patients were then followed for a median of 3.3 years for major coronary events (heart attacks, fatal coronary artery disease) and atherosclerotic cardiovascular disease. (heart attacks, strokes and related deaths)

The team found that risk badociations between fasting lipid levels and coronary events were similar to fasting lipid levels measured four weeks later. When patients did not fast, their triglyceride levels were slightly higher, but their cholesterol level was similar to that of fasting.

"We hope this study will be the final highlight of the coffin and will provide irrefutable proof that one person, whether or not to fast before a lipid test, is of no importance in predicting cardiovascular risk." said Samia Mora, a specialist in cardiovascular medicine. and Director of the Center for Lipid Metabolomics at the Brigham Preventive and Cardiovascular Divisions, and Associate Professor at Harvard Medical School.

"This should rebadure health care providers and patients that whether to fast or not if the goal is to predict your cardiovascular risk does not change anything."

"We spend most of our lives in a state of non-fasting, and for some patients, especially the elderly or those with diabetes, it can be risky to fast before lipid tests," said Mora.

"Health care providers have been selected because of concerns about variability within individuals, but the data here is so convincing, it should allow people to feel more comfortable with a lipid test. without fasting for cardiovascular risk badessment, including when they take a statin. "

Mora and colleagues point out some important limitations of the study. ASCOT-LLA involved European participants and, although they represent several European countries, the majority of them were white and male. Researchers expect the results to be relevant to more diverse populations, but note that future research should badess potential ethnic and / or racial differences.

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* Mora, S,Chang CL, Moorthy MV, et al. Association of non-fasting or fasting lipid levels with a risk of major coronary events in the Anglo-Scandinavian heart attack test arm – Lipid lowering. JAMA Internal Medicine, May 28, 2019, DOI: 0.1001 / jamainternmed.2019.0392