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

Clin Cardiol. 2018 Mar;41(3):314-320. doi: 10.1002/clc.22864. Epub 2018 Mar 25.

Abstract

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.

Keywords: Atrial Fibrillation; Blood Lipids; Epidemiology; Risk Factors.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / blood
  • Atrial Fibrillation / epidemiology*
  • Atrial Fibrillation / etiology
  • Biomarkers / blood
  • China
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Dyslipidemias / blood
  • Dyslipidemias / complications*
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Lipids / blood*
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • Time Factors
  • Young Adult

Substances

  • Biomarkers
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Lipids