Optimal cut-off points after a daily meal corresponding to fasting goal levels of LDL-C and non-HDL-C in Chinese patients with coronary heart disease

Abstract Background: Although the detection of non-fasting blood lipids has been recommended in patients with coronary heart disease (CHD), the non-fasting cut-off points corresponding to the fasting goals of LDL-C < 1.8 mmol/Land non-HDL-C < 2.6 mmol/L, respectively, have not been explored. Methods: This study enrolled 397 inpatients with CHD. One hundred and ninety-seven patients took statins for < 1 month (m) or did not take any statin before admission (i.e. CHD1 group), while 204 patients took statins for ≥ 1 m before admission (i.e. CHD2 group). Blood lipid levels were measured at 0 h, 2 h, and 4 h after a daily breakfast. Results: Non-fasting low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) levels significantly decreased after a daily meal ( P < 0.05). Both fasting and non-fasting LDL-C or non-HDL-C levels were significantly lower in the CHD2 group. The percent attainment of LDL-C < 1.8 mmol/L at 2 h or 4 h after a daily breakfast was significantly higher than that of its fasting point ( P < 0.05), whereas that of non-HDL-C < 2.6 mmol/L was significantly higher only at 4 h ( P < 0.05). Analysis of c-statistic showed that non-fasting cut-off points for LDL-C and non-HDL-C were 1.5 mmol/L and 2.4 mmol/L, corresponding to their fasting goal levels of 1.8 mmol/L and 2.6 mmol/L, respectively. When postprandial LDL-C and non-HDL-C goal attainments were re-evaluated by non-fasting cut-off points, there were no significant differences in percent attainment between fasting and non-fasting states. Conclusions: Determination ofnon-fasting cut-off points is important to evaluate the efficacy of cholesterol-lowering therapy if blood lipids are detected after a daily meal.