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)
BACKGROUND—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 RES...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2014-08, Vol.130 (7), p.546-553 |
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| creator | Doran, Bethany Guo, Yu Xu, Jinfeng Weintraub, Howard Mora, Samia Maron, David J Bangalore, Sripal |
| description | BACKGROUND—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 |
| doi_str_mv | 10.1161/CIRCULATIONAHA.114.010001 |
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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.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/CIRCULATIONAHA.114.010001</identifier><identifier>PMID: 25015340</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: by the American College of Cardiology Foundation and the American Heart Association, Inc</publisher><subject>Adult ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Cardiovascular Diseases - blood ; Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - mortality ; Cohort Studies ; Diabetes. Impaired glucose tolerance ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Disorders of blood lipids. Hyperlipoproteinemia ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Fasting - blood ; Female ; Follow-Up Studies ; Humans ; Lipoproteins, LDL - blood ; Male ; Medical sciences ; Metabolic diseases ; Middle Aged ; Mortality - trends ; Nutrition Surveys - trends ; Prognosis ; Time Factors</subject><ispartof>Circulation (New York, N.Y.), 2014-08, Vol.130 (7), p.546-553</ispartof><rights>2014 by the American College of Cardiology Foundation and the American Heart Association, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>2014 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4011-23ccc967d951fa82340cc8788d65eba6291ebbd2c79d66c2ac5f1df8d8b10d823</citedby><cites>FETCH-LOGICAL-c4011-23ccc967d951fa82340cc8788d65eba6291ebbd2c79d66c2ac5f1df8d8b10d823</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28733095$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25015340$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Doran, Bethany</creatorcontrib><creatorcontrib>Guo, Yu</creatorcontrib><creatorcontrib>Xu, Jinfeng</creatorcontrib><creatorcontrib>Weintraub, Howard</creatorcontrib><creatorcontrib>Mora, Samia</creatorcontrib><creatorcontrib>Maron, David J</creatorcontrib><creatorcontrib>Bangalore, Sripal</creatorcontrib><title>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)</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>BACKGROUND—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.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular Diseases - blood</subject><subject>Cardiovascular Diseases - diagnosis</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Cohort Studies</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Disorders of blood lipids. Hyperlipoproteinemia</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Fasting - blood</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Lipoproteins, LDL - blood</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Middle Aged</subject><subject>Mortality - trends</subject><subject>Nutrition Surveys - trends</subject><subject>Prognosis</subject><subject>Time Factors</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkd9u0zAYxS0EYmXwCujjAmlcZNhJnD9IXEShpZFChli328hxnCbg2MVOVvp8vBjeWkDccWV_R79j-_gg9IrgS0Ii8jYvvuQ3ZbYprqpsnTktvMQEY0weoQWhfuiFNEgfo4WTUi8OfP8MPbP2qxujIKZP0ZlPMaFBiBfo52ejt0rbaeBwy-QsQHewYm5WW7gVxs4WKq26k1LqvfdBKDtMByiHnd4ZPYlBQd5rKewkjJZQijshLWjlaLX1NsKM8EmbiUnnegeFc2_7CVZGjzD1Aio2DVoxCWvB5NQDUy1U82SGexmWP9g4qAcErmdzJw5QFAVcVOusWl57bv_mOXrSMWnFi9N6jm5Wy02-9sqrj0WelR4PMSGeH3DO0yhuU0o6lvguP-dJnCRtREXDIj8lomlan8dpG0XcZ5x2pO2SNmkIbh1_ji6O57rU32cXtx4Hy4WUTAk925pQGhAcRzRyaHpEudHWGtHVOzOMzBxqguv7Dut_O3RaWB87dN6Xp2vmZhTtH-fv0hzw-gQwy5nsDFN8sH-5JA4CnFLHvT9yey1dNfabnPfC1P3DN__HQ34B5mi8Pg</recordid><startdate>20140812</startdate><enddate>20140812</enddate><creator>Doran, Bethany</creator><creator>Guo, Yu</creator><creator>Xu, Jinfeng</creator><creator>Weintraub, Howard</creator><creator>Mora, Samia</creator><creator>Maron, David J</creator><creator>Bangalore, Sripal</creator><general>by the American College of Cardiology Foundation and the American Heart Association, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140812</creationdate><title>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)</title><author>Doran, Bethany ; Guo, Yu ; Xu, Jinfeng ; Weintraub, Howard ; Mora, Samia ; Maron, David J ; Bangalore, Sripal</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4011-23ccc967d951fa82340cc8788d65eba6291ebbd2c79d66c2ac5f1df8d8b10d823</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular Diseases - blood</topic><topic>Cardiovascular Diseases - diagnosis</topic><topic>Cardiovascular Diseases - mortality</topic><topic>Cohort Studies</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Disorders of blood lipids. Hyperlipoproteinemia</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Fasting - blood</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Lipoproteins, LDL - blood</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Middle Aged</topic><topic>Mortality - trends</topic><topic>Nutrition Surveys - trends</topic><topic>Prognosis</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Doran, Bethany</creatorcontrib><creatorcontrib>Guo, Yu</creatorcontrib><creatorcontrib>Xu, Jinfeng</creatorcontrib><creatorcontrib>Weintraub, Howard</creatorcontrib><creatorcontrib>Mora, Samia</creatorcontrib><creatorcontrib>Maron, David J</creatorcontrib><creatorcontrib>Bangalore, Sripal</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Doran, Bethany</au><au>Guo, Yu</au><au>Xu, Jinfeng</au><au>Weintraub, Howard</au><au>Mora, Samia</au><au>Maron, David J</au><au>Bangalore, Sripal</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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)</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2014-08-12</date><risdate>2014</risdate><volume>130</volume><issue>7</issue><spage>546</spage><epage>553</epage><pages>546-553</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>BACKGROUND—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.</abstract><cop>Hagerstown, MD</cop><pub>by the American College of Cardiology Foundation and the American Heart Association, Inc</pub><pmid>25015340</pmid><doi>10.1161/CIRCULATIONAHA.114.010001</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Cardiovascular Diseases - blood Cardiovascular Diseases - diagnosis Cardiovascular Diseases - mortality Cohort Studies Diabetes. Impaired glucose tolerance Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Disorders of blood lipids. Hyperlipoproteinemia Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Fasting - blood Female Follow-Up Studies Humans Lipoproteins, LDL - blood Male Medical sciences Metabolic diseases Middle Aged Mortality - trends Nutrition Surveys - trends Prognosis Time Factors |
| title | 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) |
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