Lipoprotein(a) elevation independently associates with incident atrial fibrillation irrespective of inflammatory

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Cell-free Biochemical Fluorometric Enzymatic Assay for High-throughput Measurement of Lipid Peroxidation in High Density Lipoprotein
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Cell-free Biochemical Fluorometric Enzymatic Assay for High-throughput Measurement of Lipid Peroxidation in High Density Lipoprotein

Published on: October 12, 2017

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Le Li1, Sheng Su1, Zhicheng Hu1

  • 1Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.

Heart Rhythm
|August 8, 2025
PubMed

Insights

Elevated lipoprotein(a) (Lp[a]) is an independent risk factor for atrial fibrillation (AF), even when systemic inflammation, measured by high-sensitivity C-reactive protein (hs-CRP), is not elevated. This finding highlights Lp[a] as a key predictor for AF development.

Area of Science:

  • Cardiovascular Medicine
  • Epidemiology
  • Biomarkers

Background:

  • Atrial fibrillation (AF) poses significant risks for stroke, heart failure, and mortality.
  • Elevated lipoprotein(a) (Lp[a]) is a suspected contributor to AF pathogenesis.
  • The interplay between Lp(a) and systemic inflammation (hs-CRP) in AF development is not well understood.

Purpose of the Study:

  • To determine if the association between Lp(a) and AF is independent of baseline inflammatory status.
  • To investigate the role of Lp(a) as a risk factor for incident AF, considering hs-CRP levels.

Main Methods:

  • Retrospective cohort study of 365,899 UK Biobank participants without baseline AF.
  • Lp(a) analyzed continuously and categorically (≥125 nmol/L); systemic inflammation defined as hs-CRP ≥2 mg/L.
  • Multivariable Cox proportional hazards and Fine-Gray competing risk models used to estimate AF risk.

Main Results:

  • Over 13.5 years, 25,048 incident AF cases were recorded.
  • Elevated Lp(a) and hs-CRP were individually associated with higher incident AF rates.
  • Higher Lp(a) levels independently predicted increased AF risk, irrespective of hs-CRP status (e.g., hs-CRP ≥2 mg/L: HR 1.12; hs-CRP <2 mg/L: HR 1.09).

Conclusions:

  • Lipoprotein(a) is confirmed as an independent risk factor for atrial fibrillation.
  • This independence holds true regardless of baseline systemic inflammatory status, as indicated by hs-CRP levels.
  • Lp(a) emerges as a crucial, inflammation-independent predictor for AF development.
Abstract

Keywords:
Atrial fibrillationHigh-sensitivity C-reactive proteinInflammationLipoprotein(a)Risk FactorsUK Biobank

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