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- W1534037293 abstract "Introduction: National guidelines recommend patients obtain fasting lipid panels for risk stratification. No studies have examined whether specific fasting time cut-points provide better prognostic ability for cardiovascular (CV) events in a national sample.Hypothesis: We tested the hypothesis that fasting and non-fasting prognostic ability for all-cause and CV mortality is different within groups stratified by length of fast definition (4, 8, or 12 hours).Methods: 16,161 individuals enrolled in the National Health and Nutrition Survey III linked to the National Death Index were stratified based on fasting status (<4 hours vs. ≥4 hours, <8 hours vs. ≥8 hours, <12 hours vs. ≥12 hours). CV and all-cause mortality were assessed after a mean of 14.0 (+/- 0.22) year follow-up. Risk of outcomes as a function of LDL-C and fasting status were stratified by cut-point and assessed using receiver operating characteristic (ROC) curves. Propensity score matching was performed after controlling for covariables in the 8 hour cut-point.Results: For cardiovascular mortality, fasting LDL-C with a cut-point of 4 hours yielded similar prognostic value as that of non-fasting LDL-C (C statistics = 0.62 [95% CI 0.60-0.64] vs. C statistics = 0.65 [95% CI 0.59-0.70]; P=0.34), as did a cut-point of 8 hours (C-statistics = 0.62 [95% CI 0.60-0.64] vs. 0.62 [95% CI 0.59-0.64]; P=0.8) and 12 hours (C statistics = 0.61 [95% CI 0.59-0.63] vs. C statistics = 0.63 [95% CI 0.61-0.65]; P=0.27). Similar results were seen for the primary outcome for all cut-points. Propensity score matched models failed to reveal a significant difference between fasting and non-fasting cohorts.Conclusions: This study shows similar prognostic value of fasting vs. non-fasting LDL-C on long-term mortality in a nationally representative U.S. cohort. National and international agencies should consider re-evaluating the recommendation that patients fast before obtaining a lipid panel. ![][1] [1]: /embed/graphic-1.gif" @default.
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- W1534037293 date "2014-11-25" @default.
- W1534037293 modified "2023-09-25" @default.
- W1534037293 title "Abstract 11268: Fasting Low Density Lipoprotein Cholesterol (LDL-C) Levels Stratified by Fasting Time Do Not Have Significant Improvement in Prognostic Value versus Non-fasting LDL-C" @default.
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!["Introduction: National guidelines recommend patients obtain fasting lipid panels for risk stratification. No studies have examined whether specific fasting time cut-points provide better prognostic ability for cardiovascular (CV) events in a national sample.Hypothesis: We tested the hypothesis that fasting and non-fasting prognostic ability for all-cause and CV mortality is different within groups stratified by length of fast definition (4, 8, or 12 hours).Methods: 16,161 individuals enrolled in the National Health and Nutrition Survey III linked to the National Death Index were stratified based on fasting status (<4 hours vs. ≥4 hours, <8 hours vs. ≥8 hours, <12 hours vs. ≥12 hours). CV and all-cause mortality were assessed after a mean of 14.0 (+/- 0.22) year follow-up. Risk of outcomes as a function of LDL-C and fasting status were stratified by cut-point and assessed using receiver operating characteristic (ROC) curves. Propensity score matching was performed after controlling for covariables in the 8 hour cut-point.Results: For cardiovascular mortality, fasting LDL-C with a cut-point of 4 hours yielded similar prognostic value as that of non-fasting LDL-C (C statistics = 0.62 [95% CI 0.60-0.64] vs. C statistics = 0.65 [95% CI 0.59-0.70]; P=0.34), as did a cut-point of 8 hours (C-statistics = 0.62 [95% CI 0.60-0.64] vs. 0.62 [95% CI 0.59-0.64]; P=0.8) and 12 hours (C statistics = 0.61 [95% CI 0.59-0.63] vs. C statistics = 0.63 [95% CI 0.61-0.65]; P=0.27). Similar results were seen for the primary outcome for all cut-points. Propensity score matched models failed to reveal a significant difference between fasting and non-fasting cohorts.Conclusions: This study shows similar prognostic value of fasting vs. non-fasting LDL-C on long-term mortality in a nationally representative U.S. cohort. National and international agencies should consider re-evaluating the recommendation that patients fast before obtaining a lipid panel. ![][1] [1]: /embed/graphic-1.gif"](?object=%22Introduction%3A%20National%20guidelines%20recommend%20patients%20obtain%20fasting%20lipid%20panels%20for%20risk%20stratification.%20No%20studies%20have%20examined%20whether%20specific%20fasting%20time%20cut-points%20provide%20better%20prognostic%20ability%20for%20cardiovascular%20(CV)%20events%20in%20a%20national%20sample.Hypothesis%3A%20We%20tested%20the%20hypothesis%20that%20fasting%20and%20non-fasting%20prognostic%20ability%20for%20all-cause%20and%20CV%20mortality%20is%20different%20within%20groups%20stratified%20by%20length%20of%20fast%20definition%20(4%2C%208%2C%20or%2012%20hours).Methods%3A%2016%2C161%20individuals%20enrolled%20in%20the%20National%20Health%20and%20Nutrition%20Survey%20III%20linked%20to%20the%20National%20Death%20Index%20were%20stratified%20based%20on%20fasting%20status%20(%3C4%20hours%20vs.%20%E2%89%A54%20hours%2C%20%3C8%20hours%20vs.%20%E2%89%A58%20hours%2C%20%3C12%20hours%20vs.%20%E2%89%A512%20hours).%20CV%20and%20all-cause%20mortality%20were%20assessed%20after%20a%20mean%20of%2014.0%20(%2B%2F-%200.22)%20year%20follow-up.%20Risk%20of%20outcomes%20as%20a%20function%20of%20LDL-C%20and%20fasting%20status%20were%20stratified%20by%20cut-point%20and%20assessed%20using%20receiver%20operating%20characteristic%20(ROC)%20curves.%20Propensity%20score%20matching%20was%20performed%20after%20controlling%20for%20covariables%20in%20the%208%20hour%20cut-point.Results%3A%20For%20cardiovascular%20mortality%2C%20fasting%20LDL-C%20with%20a%20cut-point%20of%204%20hours%20yielded%20similar%20prognostic%20value%20as%20that%20of%20non-fasting%20LDL-C%20(C%20statistics%20%3D%200.62%20%5B95%25%20CI%200.60-0.64%5D%20vs.%20C%20statistics%20%3D%200.65%20%5B95%25%20CI%200.59-0.70%5D%3B%20P%3D0.34)%2C%20as%20did%20a%20cut-point%20of%208%20hours%20(C-statistics%20%3D%200.62%20%5B95%25%20CI%200.60-0.64%5D%20vs.%200.62%20%5B95%25%20CI%200.59-0.64%5D%3B%20P%3D0.8)%20and%2012%20hours%20(C%20statistics%20%3D%200.61%20%5B95%25%20CI%200.59-0.63%5D%20vs.%20C%20statistics%20%3D%200.63%20%5B95%25%20CI%200.61-0.65%5D%3B%20P%3D0.27).%20Similar%20results%20were%20seen%20for%20the%20primary%20outcome%20for%20all%20cut-points.%20Propensity%20score%20matched%20models%20failed%20to%20reveal%20a%20significant%20difference%20between%20fasting%20and%20non-fasting%20cohorts.Conclusions%3A%20This%20study%20shows%20similar%20prognostic%20value%20of%20fasting%20vs.%20non-fasting%20LDL-C%20on%20long-term%20mortality%20in%20a%20nationally%20representative%20U.S.%20cohort.%20National%20and%20international%20agencies%20should%20consider%20re-evaluating%20the%20recommendation%20that%20patients%20fast%20before%20obtaining%20a%20lipid%20panel.%20!%5B%5D%5B1%5D%20%5B1%5D%3A%20%2Fembed%2Fgraphic-1.gif%22){kind=link}