Non-fasting and fasting tests are “not mutually exclusiveâ€
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Experts attending the European Society of Atherosclerosis (EAS) and the European Federation of Clinical Chemistry and Experimental Medicine (EFLM) unanimously stated that joint action will be taken.
They looked at the latest research from more than 300,000 people in Denmark, Canada and the United States and found no need to fasting before testing for cholesterol levels.
With the exception of Denmark, all countries require patients to be fasted for at least 8 hours before they can detect their cholesterol and triglyceride levels – known as “lipidsâ€. In Denmark, since 2009, non-fasting blood collection has been used. the way.
Their case was discussed in an article published in the European Journal of Cardiology, which experts say “a barrier to screening people†for many patients, especially children, the elderly, and people with diabetes. For the workers, it is a problem.
"Interestingly, there is a lack of evidence that fasting is better than non-fasting status when testing cardiovascular lipid levels for cardiovascular risk assessment," they noted. “However, it is more advantageous to use non-fasting specimens instead of fasting specimens to detect blood lipids.â€
Non-fasting and fasting tests are “not mutually exclusiveâ€
In this article in the journal, the researchers discussed fasting and non-fasting blood lipid testing and suggested that most patients do not need to fast, but they point out that in some cases an empty stomach is needed for testing. Should be "respected as complementary rather than mutually exclusive."
Most patients do not recommend fasting, especially if this is their first blood lipid test, cardiovascular risk assessment, or when the patient expresses a preference for non-fasting tests.
Children, elderly patients, patients undergoing stable medication, and patients with acute coronary syndrome are also not recommended for fasting – because they require repeated lipid tests, and fasting reduces blood lipid levels.
Diabetic patients should also be tested for non-fasting because of the higher risk of hypoglycemia, and because fasting may mask high triglyceride levels (hypertriglyceridemia).
If the non-fasting test shows a triglyceride level above 5 mmol/L (440 mg/L), a fasting test is required.
There are other special cases associated with hypertriglyceridemia that require fasting tests. For example, patients who are known to have hypertriglyceridemia who are followed up by a blood lipid clinic, who start medical treatment may cause severe hypertriglyceridemia, and those who have recovered from acute pancreatitis due to hypertriglyceridemia.
There may also be special circumstances where laboratory testing requires an empty or morning sample – for example, to detect fasting blood glucose or to monitor the effects of certain drugs.
However, the authors point out that even in the detection of fasting blood glucose, many countries have already used this method of fasting blood glucose testing instead of fasting glycosylated hemoglobin.
Non-fasting test "will improve patient compliance"
The research team said that in Denmark, patients, doctors and testing laboratories benefit from non-fasting tests. It reduces the cost of return visits, mail, phone calls and follow-up. The doctor can also spend less time reviewing the test results in subsequent appointments.
Börge Nordestgaard, professor of clinical medicine at the University of Copenhagen's Haleow Hospital, said that the transition to a non-fasting blood lipid test system "will improve the patient's preventive treatment aimed at reducing the number of heart attacks and strokes. The latter is full The most important cause of death in the world."
More patients receiving non-fasting tests also give doctors more opportunities to tell more people how to prevent heart attacks and strokes, B?rgeNordestgaard said:
"We hope that non-fasting cholesterol testing will enable more patients to work with their doctors to achieve lifestyle changes and, if necessary, statin therapy to reduce the global problem of cardiovascular disease and premature death."
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