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- Publisher Website: 10.1161/CIRCULATIONAHA.114.010001
- Scopus: eid_2-s2.0-84906089217
- PMID: 25015340
- WOS: WOS:000340681000011
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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)
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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Authors | |
Keywords | mortality cholesterol |
Issue Date | 2014 |
Citation | Circulation, 2014, v. 130, n. 7, p. 546-553 How to Cite? |
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. © 2014 American Heart Association, Inc. |
Persistent Identifier | http://hdl.handle.net/10722/219381 |
ISSN | 2023 Impact Factor: 35.5 2023 SCImago Journal Rankings: 8.415 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Doran, Bethany | - |
dc.contributor.author | Guo, Yu | - |
dc.contributor.author | Xu, Jinfeng | - |
dc.contributor.author | Weintraub, Howard | - |
dc.contributor.author | Mora, Samia | - |
dc.contributor.author | Maron, David J. | - |
dc.contributor.author | Bangalore, Sripal | - |
dc.date.accessioned | 2015-09-23T02:56:56Z | - |
dc.date.available | 2015-09-23T02:56:56Z | - |
dc.date.issued | 2014 | - |
dc.identifier.citation | Circulation, 2014, v. 130, n. 7, p. 546-553 | - |
dc.identifier.issn | 0009-7322 | - |
dc.identifier.uri | http://hdl.handle.net/10722/219381 | - |
dc.description.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. © 2014 American Heart Association, Inc. | - |
dc.language | eng | - |
dc.relation.ispartof | Circulation | - |
dc.subject | mortality | - |
dc.subject | cholesterol | - |
dc.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) | - |
dc.type | Article | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1161/CIRCULATIONAHA.114.010001 | - |
dc.identifier.pmid | 25015340 | - |
dc.identifier.scopus | eid_2-s2.0-84906089217 | - |
dc.identifier.volume | 130 | - |
dc.identifier.issue | 7 | - |
dc.identifier.spage | 546 | - |
dc.identifier.epage | 553 | - |
dc.identifier.eissn | 1524-4539 | - |
dc.identifier.isi | WOS:000340681000011 | - |
dc.identifier.issnl | 0009-7322 | - |