Non-Fasting Lipid Levels Can Stratify Vascular Disease Risk

Study indicates lipid assessment may be simplified
By A. Agrawal, PhD
HealthDay Reporter

TUESDAY, Nov. 10 (HealthDay News) -- The risk of coronary heart disease and ischemic stroke can be assessed by measuring cholesterol or apolipoprotein levels, without the need to fast, according to a study in the Nov. 11 issue of the Journal of the American Medical Association.

John Danesh, from the University of Cambridge in the United Kingdom, and colleagues analyzed records from 302,430 individuals without vascular disease at baseline from 68 long-term prospective studies that assessed the effect of major lipids and apolipoproteins on vascular risk. During 2.79 million person-years of follow-up, 8,857 nonfatal myocardial infarctions, 3,928 deaths from coronary heart disease, 2,534 ischemic strokes, 513 hemorrhagic strokes, and 2,536 unclassified strokes were recorded.

After adjusting for several conventional risk factors, the researchers found no association between triglyceride levels and coronary heart disease or ischemic stroke. However, high-density lipoprotein cholesterol (HDL-C) was associated with a lower risk, while non-HDL-C and directly measured low-density lipoprotein cholesterol (LDL-C) were associated with a higher risk. The level of risk was similar regardless of whether the patient had fasted. Hazard ratios with non-HDL-C and HDL-C were found to be nearly identical to those seen with apolipoprotein B and AI, and hazard ratios were similar with non-HDL-C as with directly measured LDL-C.

"Lipid assessment in vascular disease can be simplified by measurement of either total and HDL cholesterol levels or apolipoproteins without the need to fast and without regard to triglyceride," Danesh and colleagues conclude.

One author reported receiving research funding and reimbursement from pharmaceutical companies for attending scientific meetings, while another reported receiving research funding from pharmaceutical companies.

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