BROADCASTS.com

The following question refers to Section 4.6 of the 2021 ESC CV Prevention Guidelines. The question is asked by Student\xa0Dr. Shivani Reddy, answered first by Johns Hopkins Cardiology Fellow\xa0Dr. Rick Ferraro, and then by expert faculty\xa0Dr. Eileen Handberg.\n\nDr. Handberg is an Adult Nurse Practitioner, Professor of Medicine, and Director of the Cardiovascular Clinical Trials Program in the Division of Cardiovascular Medicine at the University of Florida. She has served as Chair of the Cardiovascular Team Section and the Board of Trustees with the ACC and is the President for the PCNA.\n\nThe CardioNerds Decipher The Guidelines Series for the 2021 ESC CV Prevention Guidelines\xa0represents a collaboration with the\xa0ACC Prevention of CVD Section, the\xa0National Lipid Association, and\xa0Preventive Cardiovascular Nurses Association.\n\n\n\nQuestion #22\n\n\n\nMr. HC is a 50-year-old man presenting for a routine clinic visit. He is not sure the last time he had a lipid panel drawn, and would like one today, but ate lunch just prior to your appointment \u2013 a delicious plate of 50% fruits and vegetables, 25% lean meats, and 25% whole grains as you had previously recommended.\n\nTrue or False: Mr. HC should return another day to obtain a fasting lipid panel.\n\n\nTRUE\n\n\nFALSE\n\n\n\n\n\nAnswer #22\n\n\n\nAnswer choices\nTRUE\n\n\nFALSE\n\n\nExplanation\xa0\nThis statement is False. A non-fasting lipid panel is appropriate for risk stratification and lipid evaluation in most patients per the ESC guidelines.\n\nWhile no level of evidence in provided in the ESC guidelines, this recommendation is consistent with AHA/ACC cholesterol guidelines, which have also largely moved away from fasting lipid panels for most patients and give a Class 1 (LOE B) recommendation to obtaining a fasting or nonfasting plasma lipid profile for ASCVD estimation and baseline LDL-C in adults 20 years of age or older.\n\nThe ESC recommendation is based upon large trials showing that results of fasting and non-fasting panels are largely similar. This is similar to the AHA/ACC guidelines, which note non-fasting and fasting LDL-C change minimal over time following a normal meal, while HDL-C and tryiglycerides appear to have similar prognostic significance with cardiovascular outcomes in fasting or nonfasting states.\n\nA fasting lipid panel should be considered in those with hypertriglyceridemia, metabolic syndrome, and diabetes mellitus, as consumption of food or drink can have direct and immediate effects on TG and blood glucose values.\n\n\nMain Takeaway\nA non-fasting lipid panel is appropriate for the majority of patients undergoing lipid evaluation and cardiovascular risk stratification.\xa0\n\n\nGuideline Loc.\nSection 4.6.1\n\n\n\nCardioNerds Decipher the Guidelines - 2021 ESC Prevention Series\nCardioNerds Episode Page\nCardioNerds Academy\nCardionerds Healy Honor Roll\n\nCardioNerds Journal Club\nSubscribe to The Heartbeat Newsletter!\nCheck out CardioNerds SWAG!\nBecome a CardioNerds Patron!