Association of Cardiac Events with Fasting or Nonfasting Lipid Testing

Based on several population-level analyses of the association of cardiac events with fasting and nonfasting lipid levels, several guidelines now recommend routine nonfasting assessment of lipid levels. In a patient-level analysis of data from ASCOT-LLA (NEJM JW Gen Med May 15 2003 and Lancet 2003; 361:1149), researchers identified 8270 adults (mean age, 63) whose fasting and nonfasting lipid levels were assessed at study entry. Participants had ≥3 traditional risk factors for cardiovascular disease (CVD). LDL cholesterol levels were calculated with the Friedewald equation (LDL=total cholesterol−[triglycerides/5]−HDL).

Median fasting and nonfasting levels were similar for total cholesterol (215 mg/dL) and LDL cholesterol (132 mg/dL); the medi…