Lipid profile and incidence of atrial fibrillation: A prospective cohort study in China.

The association between dyslipidemia, a major risk factor for cardiovascular diseases, and atrial fibrillation (AF) is not clear because of limited evidence. Dyslipidemia may be associated with increased risk of AF in a Chinese population. A total of 88 785 participants free from AF at baseline (2006-2007) were identified from the Kailuan Study. Fasting levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured at baseline using standard procedures. The study population was stratified based on quartiles of lipid profile. Incident AF was ascertained from electrocardiograms at biennial follow-up visits (2008-2015). The associations between incident AF and the different lipid parameters (TC, LDL-C, HDL-C, and TG) were assessed by Cox proportional hazards regression analysis. Over a mean follow-up period of 7.12 years, 328 subjects developed AF. Higher TC (hazard ratio [HR]: 0.60, 95% confidence interval [CI]: 0.43-0.84) and LDL-C (HR: 0.60, 95% CI: 0.43-0.83) levels were inversely associated with incident AF after multivariable adjustment. HDL-C and TG levels showed no association with newly developed AF. The results remained consistent after exclusion of individuals with myocardial infarction or cerebral infarction, or those on lipid-lowering therapy. Both TC/HDL-C and LDL-C/HDL-C ratios were inversely associated with risk of AF (per unit increment, HR: 0.88, 95% CI: 0.79-0.98 and HR: 0.77, 95% CI: 0.66-0.91, respectively). TC and LDL-C levels were inversely associated with incident AF, whereas no significant association of AF with HDL-C or TG levels was observed.

Li X ，Gao L ，Wang Z ，Guan B ，Guan X ，Wang B ，Han X ，Xiao X ，Waleed KB ，Chandran C ，Wu S ，Xia Y ... -  《-》

Lipid Profile and New-Onset Atrial Fibrillation in Patients With Acute ST-Segment Elevation Myocardial Infarction (An Observational Study in Southwest of China).

In acute ST-segment elevation myocardial infarction (ASTEMI), new-onset atrial fibrillation (NOAF) was not only associated with worse short-term outcomes but also with higher long-term mortality. This study aimed to evaluate the effect of dyslipidemia on the incidence of NOAF. Among the 985 patients (2014 to 2017) with ASTEMI consecutively enrolled and followed-up for 31 months in this study, 81 patients (8.2%) developed NOAF during hospitalization. Fasting levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured using standard procedures. The study population was categorized into 3 groups based on tertiles of lipid profile. Multivariate regression analysis was adjusted for baseline characteristics, laboratory values, angiography findings, and medication. Inverse associations of TC (hazard ratio [HR] 0.54, 95% confidence interval [CI] 0.32 to 0.90) and LDL-C (hazard ratio 0.56, 95% confidence interval 0.31 to 1.00) with NOAF was observed in this study. In contrast, the levels of TG and HDL-C were not associated with NOAF in patients with ASTEMI. Moreover, the all-cause mortality in the NOAF group (19.8%) was apparently higher than that in sinus rhythm goup (6.1%) after a long term follow-up. In conclusion, plasma LDL-C and TC concentrations but neither TG nor HDL-C were inversely correlated to NOAF during hospitalization, which indicated a bad prognosis even after discharge.

Xue Y ，Zhou Q ，Shen J ，Liu G ，Zhou W ，Wen Y ，Luo S ... -  《-》

Blood lipids and the incidence of atrial fibrillation: the Multi-Ethnic Study of Atherosclerosis and the Framingham Heart Study.

Dyslipidemia is a major contributor to the development of atherosclerosis and coronary disease. Its role in the etiology of atrial fibrillation (AF) is uncertain. We studied 7142 men and women from the Multi-Ethnic Study of Atherosclerosis (MESA) and the Framingham Heart Study who did not have prevalent AF at baseline and were not on lipid-lowering medications. Total cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol, and triglycerides were measured using standard procedures. Incident AF during follow-up was identified from hospital discharge codes; review of medical charts; study electrocardiograms; and, in MESA only, Medicare claims. Multivariable Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals of AF by clinical categories of blood lipids in each cohort. Study-specific results were meta-analyzed using inverse of variance weighting. During 9.6 years of mean follow-up, 480 AF cases were identified. In a combined analysis of multivariable-adjusted results from both cohorts, high levels of high-density lipoprotein cholesterol were associated with lower AF risk (hazard ratio 0.64, 95% CI 0.48 to 0.87 in those with levels ≥60 mg/dL versus <40 mg/dL), whereas high triglycerides were associated with higher risk of AF (hazard ratio 1.60, 95% CI 1.25 to 2.05 in those with levels ≥200 mg/dL versus <150 mg/dL). Total cholesterol and low-density lipoprotein cholesterol were not associated with the risk of AF. In these 2 community-based cohorts, high-density lipoprotein cholesterol and triglycerides but not low-density lipoprotein cholesterol or total cholesterol were associated with the risk of AF, accounting for other cardiometabolic risk factors.

Alonso A ，Yin X ，Roetker NS ，Magnani JW ，Kronmal RA ，Ellinor PT ，Chen LY ，Lubitz SA ，McClelland RL ，McManus DD ，Soliman EZ ，Huxley RR ，Nazarian S ，Szklo M ，Heckbert SR ，Benjamin EJ ... -  《Journal of the American Heart Association》

Blood lipid levels and recurrence of atrial fibrillation after radiofrequency catheter ablation: a prospective study.

Shang Y ，Chen N ，Wang Q ，Zhuo C ，Zhao J ，Lv N ，Huang Y ... -  《-》

Blood lipid profiles and risk of atrial fibrillation: A systematic review and meta-analysis of cohort studies.

There is an increasing body of evidence associating traditional cardiovascular risk factors with atrial fibrillation (AF), but the relationship between blood lipid profiles and the risk of AF remains controversial. This study aimed to conduct a systemic review and meta-analysis of large cohort studies to evaluate the relationship between blood lipid profiles and incident AF. PubMed and Embase were searched up to January 31, 2019, for cohort studies that reported the relationship between blood lipid levels and incident AF. The hazard ratios or odds ratios of the highest vs lowest categories of lipid levels were extracted to calculate pooled estimates. Sensitivity analysis and meta-regression were performed to explore potential sources of heterogeneity. Eleven studies were included in the meta-analysis, including 9 studies for total cholesterol (TC), 5 for low-density lipoprotein cholesterol (LDL-C), 8 for high-density lipoprotein cholesterol (HDL-C), and 8 for triglyceride. Serum TC and LDL-C levels were inversely related to AF risk (relative risk [RR] = 0.81, 95% confidence interval [CI]: 0.72-0.92; RR = 0.79, 95% CI: 0.70-0.88, respectively). Likewise, elevated HDL-C levels were associated with a reduced AF risk (RR = 0.86, 95% CI: 0.76-0.97), whereas no significant association was observed between triglyceride levels and incident AF (RR = 1.02, 95% CI: 0.90-1.17). Our meta-analysis of large cohort studies found an inverse relationship between serum TC, LDL-C, and HDL-C levels and AF risk, although there was no significant association between TG levels and incident AF. Future studies regarding AF risk stratification may take these blood lipids into consideration, and further efforts are needed to investigate the potential mechanisms.

Guan B ，Li X ，Xue W ，Tse G ，Waleed KB ，Liu Y ，Zheng M ，Wu S ，Xia Y ，Ding Y ... -  《-》