Risk of misclassification with a non-fasting lipid profile in secondary cardiovascular prevention
| Autor: | Henricus J Vermeer, Boudewijn Klop, Simone C.C. Hartong, Mariette W.C.J. Schoofs, Marcel J.M. Kofflard |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Apolipoprotein B Clinical Biochemistry 030204 cardiovascular system & hematology Biochemistry Lipid-lowering therapy 03 medical and health sciences 0302 clinical medicine Treatment targets Cardiovascular prevention Predictive Value of Tests Reference Values Internal medicine medicine Humans 030212 general & internal medicine Non fasting Aged medicine.diagnostic_test biology business.industry Biochemistry (medical) Non hdl c General Medicine Fasting Middle Aged Lipids Endocrinology Cardiovascular Diseases biology.protein lipids (amino acids peptides and proteins) Female Lipid profile business Blood Chemical Analysis |
| Zdroj: | Clinica chimica acta; international journal of clinical chemistry. 472 |
| ISSN: | 1873-3492 |
| Popis: | Routinely fasting is not necessary for measuring the lipid profile according to the latest European consensus. However, LDL-C tends to be lower in the non-fasting state with risk of misclassification. The extent of misclassification in secondary cardiovascular prevention with a non-fasting lipid profile was investigated.329 patients on lipid lowering therapy for secondary cardiovascular prevention measured a fasting and non-fasting lipid profile. Cut-off values for LDL-C, non-HDL-C and apolipoprotein B were set at1.8mmol/l,2.6mmol/l and0.8g/l, respectively. Study outcomes were net misclassification with non-fasting LDL-C (calculated using the Friedewald formula), direct LDL-C, non-HDL-C and apolipoprotein B. Net misclassification10% was considered clinically irrelevant. Mean age was 68.3±8.5years and the majority were men (79%). Non-fasting measurements resulted in lower LDL-C (-0.2±0.4mmol/l, P0.001), direct LDL-C (-0.1±0.2mmol/l, P=0.001), non-HDL-C (-0.1±0.4mmol/l, P=0.004) and apolipoprotein B (-0.02±0.10g/l, P=0.004). 36.0% of the patients reached a fasting LDL-C target of1.8mmol/l with a significant net misclassification of 10.7% (95% CI 6.4-15.0%) in the non-fasting state. In the non-fasting state net misclassification with direct LDL-C was 5.7% (95% CI 2.1-9.2%), 4.0% (95% CI 1.0-7.4%) with non-HDL-C and 4.1% (95% CI 1.1-9.1%) with apolipoprotein B.Use of non-fasting LDL-C as treatment target in secondary cardiovascular prevention resulted in significant misclassification with subsequent risk of undertreatment, whereas non-fasting direct LDL-C, non-HDL-C and apolipoprotein B are reliable parameters. |
| Databáze: | OpenAIRE |
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