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

• Published in: Clinical cardiology (Mahwah, N.J.) Vol. 41; no. 3; pp. 314 - 320
• Main Authors: Li, Xintao, Gao, Lianjun, Wang, Zhao, Guan, Bo, Guan, Xumin, Wang, Binhao, Han, Xu, Xiao, Xianjie, Waleed, Khalid Bin, Chandran, Clarance, Wu, Shouling, Xia, Yunlong
• Format: Journal Article
• Language: English
• Published: New York Wiley Periodicals, Inc 01.03.2018; John Wiley & Sons, Inc
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Atrial Fibrillation; Atrial Fibrillation - blood; Atrial Fibrillation - epidemiology; Atrial Fibrillation - etiology; Biomarkers - blood; Blood Lipids; Cardiac arrhythmia; China; Cholesterol; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Clinical Investigations; Cohort analysis; Dyslipidemias - blood; Dyslipidemias - complications; Electrocardiography; Epidemiology; Female; Follow-Up Studies; Health risk assessment; Humans; Incidence; Lipids; Lipids - blood; Low density lipoprotein; Male; Metabolic disorders; Middle Aged; Prospective Studies; Risk Assessment - methods; Risk Factors; Time Factors; Young Adult; Atrial Fibrillation; Epidemiology; Risk Factors; Blood Lipids
• ISSN: 0160-9289; 1932-8737
• DOI: 10.1002/clc.22864

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.