It is not necessary to fast before the complete cholesterol test

A new study adds to the growing body of evidence that it is useless for the largest number of patients to fast before taking blood tests to measure lipid levels to determine the risk of developing fats. future cardiovascular events. Since the 1970s, studies have suggested that fasting and non-fasting before a complete cholesterol test, also called lipid test, may have little importance in assessing the risk of seizure cardiac, stroke or other cardiovascular event. But most of these studies have been conducted comparing groups of people at the population level rather than the same individuals. This left a lingering question about the ability of non-persistent lipid levels to predict future events for patients. A large study conducted by investigators from Brigham and Women's Hospital, Harvard Medical School and Imperial College provides strong evidence that non-fast lipid levels were similar to fasting lipid levels at the same people, predicting cardiovascular risk just as well. The results are published in JAMA Internal Medicine.

"We hope this study will be the final nail of the coffin and provide irrefutable evidence that whether or not the same person fasting before a lipid test is of no importance in predicting cardiovascular risk." ", said the corresponding author Samia Mora, MD. MHS, Cardiovascular Medicine Specialist and Director of the Center for Lipid Metabolomics at the Brigham Preventive and Cardiovascular Divisions, and Associate Professor at Harvard Medical School. "This should reassure health care providers and patients that whether to fast or not if the goal is to predict your cardiovascular risk does not change anything."

To conduct their study, Mora and colleagues conducted a post-hoc prospective follow-up study of participants in the Anglo-Scandinavian Cardiac Outcome Trial (ASCOT-LLA) group, a randomized clinical trial. Fasting and fasting lipid levels in more than 8,000 participants were measured at four weeks apart, with no intermediate intervention. Patients were followed for an average of 3.3 years for major coronary events (heart attacks, fatal coronary heart disease) and atherosclerotic cardiovascular diseases (heart attacks, strokes and related deaths).

The team found that risk associations 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 spend most of our lives in critical condition, and for some patients, especially the elderly or those with diabetes, it can be risky to fast before the lipid test," 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 resistance for cardiovascular risk assessment, 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 assess potential ethnic and / or racial differences.