Use of nonfasting blood samples for lipid testing

A joint statement published online in April 2016 in the European Heart Journal recommends that "nonfasting blood samples be routinely used for the assessment of plasma lipid profiles".

The report was compiled by experts from eight European countries plus Australia, and the US. They go on to state that clinicians should consider repeating a nonfasting lipid profile test with a fasting test if plasma triglycerides are above 5 mmol/L. They also recommend that any patient with life-threatening or extremely high concentrations of triglycerides or LDL cholesterol should be referred to a lipid clinic or a physician who specialises in lipid disorders.

The use of nonfasting blood samples for lipid profiles has been recommended in Denmark since 2009 and in the UK since 2014. However the 2013 American College of Cardiology/American Heart Association (ACC/AHA) Task Force on Practice Guidelines recommended that a fasting blood sample is "preferred" for lipid testing, although a nonfasting blood sample could be used.

The joint statement says that "a nonfasting sample can routinely be used to assess plasma lipid profiles in most situations," including an initial lipid profile test in any patient; for a cardiovascular risk assessment; for a patient admitted with acute coronary syndrome; in children; in patients who prefer this; in diabetic patients (due to hypoglycaemic risk); in the elderly; and in patients on stable drug therapy.

The advantage of nonfasting samples is that people do not have to make an appointment for blood collection and the early morning crowds in collection centres will be reduced.

In Australia fasting samples are still recommended but this may change in the future.

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