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Lipid profile and incidence of atrial fibrillation: A prospective cohort study in China
Xintao Li1, Lianjun Gao1, Zhao Wang1
1Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China.
Insights
Higher total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were linked to a lower risk of atrial fibrillation (AF) in a large Chinese study. These findings suggest a complex relationship between lipid levels and AF development.
Area of Science:
- Cardiology
- Epidemiology
- Metabolic Disorders
Background:
- Dyslipidemia is a significant risk factor for cardiovascular diseases.
- The relationship between dyslipidemia and atrial fibrillation (AF) remains unclear due to limited evidence.
Purpose of the Study:
- To investigate the association between dyslipidemia and the risk of developing AF in a Chinese population.
- To determine if specific lipid parameters (TC, LDL-C, HDL-C, TG) influence incident AF.
Main Methods:
- A cohort of 88,785 participants without AF at baseline (2006-2007) from the Kailuan Study was analyzed.
- Fasting lipid profiles (TC, LDL-C, HDL-C, TG) were measured, and incident AF was tracked via electrocardiograms from 2008-2015.
- Cox proportional hazards regression models were used to assess the association between lipid levels and AF incidence.
Main Results:
- Over 7.12 years, 328 participants developed AF.
- Higher total cholesterol (TC) and LDL-C levels showed an inverse association with incident AF (HR: 0.60 for both).
- No significant association was found between HDL-C, TG levels, and AF risk. Lipid ratios (TC/HDL-C, LDL-C/HDL-C) were also inversely associated with AF risk.
Conclusions:
- Elevated TC and LDL-C levels are inversely associated with the risk of developing AF.
- No significant link was observed between HDL-C or TG levels and AF incidence.
- These findings contribute to understanding the complex interplay between lipid metabolism and atrial fibrillation.
Background:
The association between dyslipidemia, a major risk factor for cardiovascular diseases, and atrial fibrillation (AF) is not clear because of limited evidence.
Hypothesis:
Dyslipidemia may be associated with increased risk of AF in a Chinese population.
Methods:
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.
Results:
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).
Conclusions:
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.
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