Lipid Levels and New-Onset Atrial Fibrillation in Patients with Acute Myocardial Infarction

J Atheroscler Thromb. 2023 May 1;30(5):515-530. doi: 10.5551/jat.63574. Epub 2022 Jul 22.

Abstract

Aim: In acute myocardial fraction (AMI) patients, the association between lipid parameters and new-onset atrial fibrillation (NOAF) remains unclear due to limited evidence.

Methods: A total of 4282 participants free from atrial fibrillation (AF) at baseline were identified in Beijing Friendship Hospital. Fasting levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured at baseline. The study population was stratified based on tertiles of lipid profile and lipid ratios. Incidence of NOAF was observed at the follow-up visits. The associations between different lipid parameters and the incidence of NOAF were assessed by multivariate Cox regression analysis.

Results: Over a median follow-up period of 42.0 months (IQR: 18.7, 67.3 months), 3.1% (N=132) AMI patients developed NOAF. After multivariable adjustment, higher TC (hazard ratios (HR): 0.205, 95% confidence intervals (CI): 0.061-0.696) levels were inversely associated with NOAF development. However, higher HDL-C (HR: 1.892, 95% CI: 1.133-3.159) levels were positively associated with NOAF development. LDL-C levels, TG levels, non-HDL-C levels, and lipid ratios showed no association with NOAF development.

Conclusion: TC levels were inversely associated with incidence of NOAF; this was mainly reflected in the subgroups of male gender and older patients (65 years or older). HDL-C levels were positively associated with incidence of NOAF; this was mainly reflected in the subgroups of male gender and younger patients (age <65 years). There was no significant association of NOAF with LDL-C, TG, or non-HDL-C levels.

Keywords: Acute myocardial infraction; Atrial fibrillation; Hyperlipidemia; Lipid.

MeSH terms

  • Aged
  • Atrial Fibrillation* / complications
  • Atrial Fibrillation* / epidemiology
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Humans
  • Male
  • Myocardial Infarction* / complications
  • Myocardial Infarction* / epidemiology
  • Risk Factors
  • Triglycerides

Substances

  • Cholesterol, LDL
  • Triglycerides
  • Cholesterol, HDL