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 ... -  《-》

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 ... -  《-》

The Relationship between Blood Lipids and Risk of Atrial Fibrillation: Univariable and Multivariable Mendelian Randomization Analysis.

Yang S ，Pudasaini R ，Zhi H ，Wang L ... -  《Nutrients》

Lipid levels and risk of new-onset atrial fibrillation: A systematic review and dose-response meta-analysis.

Lipid levels are closely associated with health, but whether lipid levels are associated with atrial fibrillation (AF) remains controversial. We thought that blood lipid levels may influence new-onset AF. Here, we used a meta-analysis to examine the overall association between lipid levels and new-onset AF. PubMed and EMBASE databases were searched up to 20 December 2019. We conducted a systematic review and quantitative meta-analysis of prospective studies to clarify the association between lipid levels and the risk of new-onset AF. Sixteen articles with data on 4 032 638 participants and 42 825 cases of AF were included in this meta-analysis. The summary relative risk (RR) for a 1 mmol/L increment in total cholesterol (TC) was 0.95 (95% CI 0.93-0.96, I2 = 74.6%, n = 13). Subgroup analyses showed that follow-up time is a source of heterogeneity; for low-density lipoprotein cholesterol (LDL-C), RR was 0.95 (95% CI 0.92-0.97, I2 = 71.5%, n = 10). Subgroup analyses indicated that adjusting for heart failure explains the source of heterogeneity; for high-density lipoprotein cholesterol (HDL-C), RR was 0.97 (95% CI 0.96-0.99, I2 = 26.1%, n = 11); for triglycerides (TGs), RR was 1.00 (95% CI 0.96-1.03, I2 = 81.1%, n = 8). Subgroup analysis showed that gender, age, follow-up time, and adjustment for heart failure are sources of heterogeneity. Higher levels of TC, LDL-C, and HDL-C were associated with lower risk of new-onset AF. TG levels were not associated with new-onset AF in all subjects.

Yao Y ，Liu F ，Wang Y ，Liu Z ... -  《-》

Association of Lipid-Related Genetic Variants with the Incidence of Atrial Fibrillation: The AFGen Consortium.

Norby FL ，Eryd SA ，Niemeijer MN ，Rose LM ，Smith AV ，Yin X ，Agarwal SK ，Arking DE ，Chasman DL ，Chen LY ，Eijgelsheim M ，Engström G ，Franco OH ，Heeringa J ，Hindy G ，Hofman A ，Lutsey PL ，Magnani JW ，McManus DD ，Orho-Melander M ，Pankow JS ，Rukh G ，Schulz CA ，Uitterlinden AG ，Albert CM ，Benjamin EJ ，Gudnason V ，Smith JG ，Stricker BH ，Alonso A ... -  《-》