TY - JOUR
T1 - Blood lipid levels, lipid-lowering medications, and the incidence of atrial fibrillation :The atherosclerosis risk in communities study
AU - Lopez, Faye L.
AU - Agarwal, Sunil K.
AU - MacLehose, Richard F.
AU - Soliman, Elsayed Z.
AU - Sharrett, A. Richey
AU - Huxley, Rachel R.
AU - Konety, Suma
AU - Ballantyne, Christie M.
AU - Alonso, Alvaro
PY - 2012/2
Y1 - 2012/2
N2 - Background-Several cardiovascular risk factors have been associated with the risk of atrial fibrillation (AF). Limited and inconsistent evidence exists on the association of blood lipid levels and lipid-lowering medication use with AF risk. Methods and Results-We analyzed 13 969 participants (25% African American, 45% men) free of AF at baseline from the Atherosclerosis Risk in Communities study. Fasting high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), triglycerides, and total cholesterol were measured at baseline (1987-1989) and each of 3 follow-up visits. The incidence of AF was ascertained through 2007. The association of the use of statins and other lipid-lowering medications with AF was estimated in 13 044 Atherosclerosis Risk in Communities participants attending visit 2 (1990 -1992), adjusting for covariates from the previous visit. During a median follow-up of 18.7 years, there were 1433 incident AF cases. Multivariable hazard ratios (HRs) and 95% CIs of AF associated with a 1-SD increase in lipid levels were as follows: HDLc, 0.97 (0.91-1.04); LDLc, 0.90 (0.85- 0.96); total cholesterol, 0.89 (0.84-0.95); and triglycerides, 1.00 (0.96 -1.04). Participants taking lipid-lowering medications had an adjusted HR (95% CI) of AF of 0.96 (0.82-1.13) compared with those not taking medications, whereas those taking statins had an adjusted HR of 0.91 (0.66 -1.25) compared with those taking other lipid-lowering medications. Conclusions-Higher levels of LDLc and total cholesterol were associated with a lower incidence of AF. However, HDLc and triglycerides were not independently associated with AF incidence. No association was found between the use of lipid-lowering medications and incident AF.
AB - Background-Several cardiovascular risk factors have been associated with the risk of atrial fibrillation (AF). Limited and inconsistent evidence exists on the association of blood lipid levels and lipid-lowering medication use with AF risk. Methods and Results-We analyzed 13 969 participants (25% African American, 45% men) free of AF at baseline from the Atherosclerosis Risk in Communities study. Fasting high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), triglycerides, and total cholesterol were measured at baseline (1987-1989) and each of 3 follow-up visits. The incidence of AF was ascertained through 2007. The association of the use of statins and other lipid-lowering medications with AF was estimated in 13 044 Atherosclerosis Risk in Communities participants attending visit 2 (1990 -1992), adjusting for covariates from the previous visit. During a median follow-up of 18.7 years, there were 1433 incident AF cases. Multivariable hazard ratios (HRs) and 95% CIs of AF associated with a 1-SD increase in lipid levels were as follows: HDLc, 0.97 (0.91-1.04); LDLc, 0.90 (0.85- 0.96); total cholesterol, 0.89 (0.84-0.95); and triglycerides, 1.00 (0.96 -1.04). Participants taking lipid-lowering medications had an adjusted HR (95% CI) of AF of 0.96 (0.82-1.13) compared with those not taking medications, whereas those taking statins had an adjusted HR of 0.91 (0.66 -1.25) compared with those taking other lipid-lowering medications. Conclusions-Higher levels of LDLc and total cholesterol were associated with a lower incidence of AF. However, HDLc and triglycerides were not independently associated with AF incidence. No association was found between the use of lipid-lowering medications and incident AF.
KW - Atrial fibrillation
KW - Epidemiology
KW - Lipids
KW - Statins
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UR - http://www.scopus.com/inward/citedby.url?scp=84858326461&partnerID=8YFLogxK
U2 - 10.1161/CIRCEP.111.966804
DO - 10.1161/CIRCEP.111.966804
M3 - Article
C2 - 22227953
AN - SCOPUS:84858326461
SN - 1941-3149
VL - 5
SP - 155
EP - 162
JO - Circulation: Arrhythmia and Electrophysiology
JF - Circulation: Arrhythmia and Electrophysiology
IS - 1
ER -