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Effect of hospitalization on high-density lipoprotein cholesterol in patients undergoing elective coronary
J J Genest1, H M Corbett, J R McNamara
1U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Medford, Massachusetts.
Insights
Fasting lipid profiles in coronary artery disease patients differ based on sampling time. High-density lipoprotein cholesterol was significantly lower before catheterization than in a free-living state.
Area of Science:
- Cardiovascular Medicine
- Clinical Chemistry
Background:
- Plasma lipid and lipoprotein cholesterol levels are crucial biomarkers in cardiovascular disease management.
- Sampling time can influence biochemical measurements, potentially affecting clinical interpretation.
Purpose of the Study:
- To investigate the impact of sampling time on plasma lipids and lipoprotein cholesterol concentrations in patients undergoing coronary angiography.
- To determine if lipid profiles obtained before catheterization differ from those in a free-living state.
Main Methods:
- Eighty-eight patients undergoing elective coronary angiography were studied.
- Blood samples were collected in a fasting state before catheterization and in a free-living state at least 30 days post-discharge.
- Total cholesterol, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were measured.
Main Results:
- No significant differences were observed in total cholesterol, triglycerides, or calculated low-density lipoprotein cholesterol between the two sampling times.
- High-density lipoprotein cholesterol levels were significantly lower (p < 0.0001) before catheterization (32 ± 10 mg/dl) compared to the free-living state (37 ± 10 mg/dl).
- The frequency of low high-density lipoprotein cholesterol (< 35 mg/dl) was substantially higher before catheterization (77%) versus the free-living state (44%).
Conclusions:
- Sampling time significantly affects high-density lipoprotein cholesterol measurements in patients with coronary artery disease.
- A screening lipid profile for these patients should ideally be performed in a free-living state to obtain more representative values.
Abstract:
The effects of time of sampling on plasma lipids and lipoprotein cholesterol concentrations were investigated in 88 patients undergoing elective coronary angiography. Patients with a myocardial infarction or major surgery within 6 weeks before catheterization were excluded. All subjects were sampled in the fasting state at the time of arteriotomy before systemic heparinization and at least 30 days after discharge from the hospital (mean 275 days) in the free living state. No statistically significant differences were noted in total cholesterol (220 +/- 51 vs 226 +/- 48 mg/dl), triglycerides (191 +/- 77 vs 191 +/- 113 mg/dl) and calculated low-density lipoprotein cholesterol levels (149 +/- 46 vs 150 +/- 43 mg/dl). High-density lipoprotein cholesterol values were significantly lower (p less than 0.0001) in subjects sampled before catheterization than in the free living state (32 +/- 10 vs 37 +/- 10 mg/dl, mean change 14%). Moreover, the frequency of high-density lipoprotein cholesterol less than 35 mg/dl was 77% before catheterization and 44% in the free living state. This effect was neither due to beta-adrenergic drugs nor to the length of time between samplings. In view of these findings, a screening lipid profile for patients with coronary artery disease should be performed in the free living state.