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Article: Prognostic value of fasting versus nonfasting low-density lipoprotein cholesterol levels on long-term mortality: Insight from the national health and nutrition examination survey III (NHANES-III)

TitlePrognostic value of fasting versus nonfasting low-density lipoprotein cholesterol levels on long-term mortality: Insight from the national health and nutrition examination survey III (NHANES-III)
Authors
Keywordsmortality
cholesterol
Issue Date2014
Citation
Circulation, 2014, v. 130, n. 7, p. 546-553 How to Cite?
AbstractBackground-National and international guidelines recommend fasting lipid panel measurement for risk stratification of patients for prevention of cardiovascular events. However, the prognostic value of fasting versus nonfasting low-density lipoprotein cholesterol (LDL-C) is uncertain. Methods and Results-Patients enrolled in the National Health and Nutrition Examination Survey III (NHANES-III), a nationally representative cross-sectional survey performed from 1988 to 1994, were stratified on the basis of fasting status (8 or <8 hours) and followed for a mean of 14.0 (±0.22) years. Propensity score matching was used to assemble fasting and nonfasting cohorts with similar baseline characteristics. The risk of outcomes as a function of LDL-C and fasting status was assessed with the use of receiver operating characteristic curves and bootstrapping methods. The interaction between fasting status and LDL-C was assessed with Cox proportional hazards modeling. Primary outcome was all-cause mortality. Secondary outcome was cardiovascular mortality. One-to-one matching based on propensity score yielded 4299 pairs of fasting and nonfasting individuals. For the primary outcome, fasting LDL-C yielded prognostic value similar to that for nonfasting LDL-C (C statistic=0.59 [95% confidence interval, 0.57-0.61] versus 0.58 [95% confidence interval, 0.56-0.60]; P=0.73), and LDL-C by fasting status interaction term in the Cox proportional hazards model was not significant (Pinteraction=0.11). Similar results were seen for the secondary outcome (fasting versus nonfasting C statistic=0.62 [95% confidence interval, 0.60-0.66] versus 0.62 [95% confidence interval, 0.60-0.66]; P=0.96; Pinteraction=0.34). Conclusions-Nonfasting LDL-C has prognostic value similar to that of fasting LDL-C. National and international agencies should consider reevaluating the recommendation that patients fast before obtaining a lipid panel. © 2014 American Heart Association, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/219381
ISSN
2015 Impact Factor: 17.047
2015 SCImago Journal Rankings: 7.853
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorDoran, Bethany-
dc.contributor.authorGuo, Yu-
dc.contributor.authorXu, Jinfeng-
dc.contributor.authorWeintraub, Howard-
dc.contributor.authorMora, Samia-
dc.contributor.authorMaron, David J.-
dc.contributor.authorBangalore, Sripal-
dc.date.accessioned2015-09-23T02:56:56Z-
dc.date.available2015-09-23T02:56:56Z-
dc.date.issued2014-
dc.identifier.citationCirculation, 2014, v. 130, n. 7, p. 546-553-
dc.identifier.issn0009-7322-
dc.identifier.urihttp://hdl.handle.net/10722/219381-
dc.description.abstractBackground-National and international guidelines recommend fasting lipid panel measurement for risk stratification of patients for prevention of cardiovascular events. However, the prognostic value of fasting versus nonfasting low-density lipoprotein cholesterol (LDL-C) is uncertain. Methods and Results-Patients enrolled in the National Health and Nutrition Examination Survey III (NHANES-III), a nationally representative cross-sectional survey performed from 1988 to 1994, were stratified on the basis of fasting status (8 or <8 hours) and followed for a mean of 14.0 (±0.22) years. Propensity score matching was used to assemble fasting and nonfasting cohorts with similar baseline characteristics. The risk of outcomes as a function of LDL-C and fasting status was assessed with the use of receiver operating characteristic curves and bootstrapping methods. The interaction between fasting status and LDL-C was assessed with Cox proportional hazards modeling. Primary outcome was all-cause mortality. Secondary outcome was cardiovascular mortality. One-to-one matching based on propensity score yielded 4299 pairs of fasting and nonfasting individuals. For the primary outcome, fasting LDL-C yielded prognostic value similar to that for nonfasting LDL-C (C statistic=0.59 [95% confidence interval, 0.57-0.61] versus 0.58 [95% confidence interval, 0.56-0.60]; P=0.73), and LDL-C by fasting status interaction term in the Cox proportional hazards model was not significant (Pinteraction=0.11). Similar results were seen for the secondary outcome (fasting versus nonfasting C statistic=0.62 [95% confidence interval, 0.60-0.66] versus 0.62 [95% confidence interval, 0.60-0.66]; P=0.96; Pinteraction=0.34). Conclusions-Nonfasting LDL-C has prognostic value similar to that of fasting LDL-C. National and international agencies should consider reevaluating the recommendation that patients fast before obtaining a lipid panel. © 2014 American Heart Association, Inc.-
dc.languageeng-
dc.relation.ispartofCirculation-
dc.subjectmortality-
dc.subjectcholesterol-
dc.titlePrognostic value of fasting versus nonfasting low-density lipoprotein cholesterol levels on long-term mortality: Insight from the national health and nutrition examination survey III (NHANES-III)-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.1161/CIRCULATIONAHA.114.010001-
dc.identifier.pmid25015340-
dc.identifier.scopuseid_2-s2.0-84906089217-
dc.identifier.volume130-
dc.identifier.issue7-
dc.identifier.spage546-
dc.identifier.epage553-
dc.identifier.eissn1524-4539-
dc.identifier.isiWOS:000340681000011-

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