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Published on: February 26, 2013
Low lipoprotein(a) concentration is associated with atrial fibrillation: a large retrospective cohort study
Junjie Tao1,2, Xinlei Yang3, Qingkai Qiu1,2
1Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China.
Insights
Low serum lipoprotein(a) [Lp(a)] levels are linked to a higher risk of atrial fibrillation (AF), particularly in women. This finding suggests Lp(a) may aid in AF risk stratification for females.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Epidemiology
Background:
- The association between serum lipoprotein(a) [Lp(a)] levels and atrial fibrillation (AF) remains unclear, particularly within the Chinese population.
- Investigating Lp(a) levels is crucial for understanding AF pathogenesis and developing targeted prevention strategies.
Purpose of the Study:
- To determine the relationship between serum Lp(a) quantiles and the prevalence of atrial fibrillation (AF) in a Chinese cohort.
- To explore the potential of Lp(a) as a biomarker for AF risk stratification, especially in specific demographic groups.
Main Methods:
- Retrospective analysis of electronic health records from 4,511 AF patients and 9,022 controls (2017-2021).
- Propensity score matching (PSM) was employed to create comparable case and control groups.
- Logistic regression and stratified analyses were used to examine interactions between AF, Lp(a) quantiles, and clinical factors.
Main Results:
- Patients with AF exhibited significantly lower median Lp(a) levels compared to those without AF (15.95 vs. 16.90 mg/dL; P < 0.001).
- Lower Lp(a) quantiles (Q1-Q3) were associated with an increased prevalence of AF in unadjusted models.
- An inverse association between Lp(a) levels < 32.42 mg/dL and AF was observed in the adjusted model. Stratified analysis revealed a significant negative correlation between Lp(a) and AF in female patients (OR of Q1: 1.394 [1.194-1.626]).
Conclusions:
- Low serum Lp(a) levels are significantly associated with an increased risk of AF, particularly in the female Han Chinese population.
- Serum Lp(a) may serve as a valuable biomarker for identifying individuals at higher risk of developing AF, especially among women.
Background And Aims:
The role of serum lipoprotein(a) [Lp(a)] levels in atrial fibrillation (AF) is still uncertain, especially in the Chinese population. Here, we aimed to elucidate the potential relationship between Lp(a) quantiles and AF.
Methods:
All data were collected through inpatients with electronic health records from the Second Affiliated Hospital of Nanchang University, Jiangxi Province, China. The propensity score matching (PSM) method was used to match control and case groups. Interactions between AF, Lp(a) quantiles, and other clinical indices were analyzed by logistic regression and stratified analysis. Statistical analyses were performed with IBM SPSS statistical software and R software.
Results:
From 2017 to 2021, 4,511 patients with AF and 9,022 patients without AF were 1:2 matched by the propensity score matching method. A total of 46.9% of the study group was women, and the baseline mean age was 65 years. The AF group exhibited lower median Lp(a) than the non-AF group (15.95 vs. 16.90 mg/dL; P < 0.001). Based on the Lp(a) quantiles, the study population was divided into four groups: Q1 (≤ 8.71 mg/dL), Q2 (8.71-16.54 mg/dL), Q3 (16.54-32.42 mg/dL) and Q4 (> 32.42 mg/dL). The AF prevalence of each group decreased from 34.2% (Q1) to 30.9% (Q4) (P < 0.001). Lp(a) quantiles 1-3 significantly increased AF to 1.162-fold (1.049-1.286), 1.198-fold (1.083-1.327), and 1.111-fold (1.003-1.231) in the unadjusted logistic regression model, respectively. In the adjusted model, Lp(a) < 32.42 mg/dL still showed a significant inverse association with AF. In the stratified analysis, Lp(a) levels in female patients exhibited a significant negative correlation with AF (OR of Q1: 1.394[1.194-1.626], P = 0.001). Age and hypertension did not affect the adverse correlation.
Conclusion:
Low circulating Lp(a) levels were associated with AF, especially in the female Han population, suggesting that Lp(a) may be useful for risk stratification of AF in female individuals.
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