Evaluation of the Paradoxical Association Between Lipid Levels and Incident Atrial Fibrillation According to Statin Usage: A Nationwide Cohort Study.

Ahn, Hyo-Jeong ORCID: 0000-0003-3590-0378, Lee, So-Ryoung ORCID: 0000-0002-6351-5015, Choi, Eue-Keun ORCID: 0000-0002-0411-6372, Lee, Seung-Woo ORCID: 0000-0003-3389-8219, Han, Kyung-Do ORCID: 0000-0002-9622-0643, Kwon, Soonil ORCID: 0000-0002-4791-6855, Oh, Seil ORCID: 0000-0002-2504-9615 and Lip, Gregory YH ORCID: 0000-0002-7566-1626 (2023) Evaluation of the Paradoxical Association Between Lipid Levels and Incident Atrial Fibrillation According to Statin Usage: A Nationwide Cohort Study. Journal of lipid and atherosclerosis, 12 (1). pp. 73-86.

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Abstract

<h4>Objective</h4>Higher levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) are associated with a lower risk of atrial fibrillation (AF). Statin use might exert confounding effects on the paradoxical associations; however, the relationships that distinguish statin users from non-users have not been thoroughly evaluated.<h4>Methods</h4>From the Korean National Health Insurance Database, we included 9,778,014 adults who underwent a health examination in 2009. The levels of TC and LDL-C at the health examination were categorized into quartile values of the total study population. We grouped the study population into statin users and non-users and investigated the associations between TC, LDL-C, and the risk of incident AF.<h4>Results</h4>Of the total population, 867,336 (8.9%) were taking statins. During a mean follow-up of 8.2 years, inverse associations of TC - AF and LDL-C - AF were observed; higher levels of TC and LDL-C were associated with the lower risk of AF in the total population. Overall, statin users showed higher AF incidence rate than non-users, but the inverse associations of TC - AF and LDL-C - AF were consistently observed irrespective of statin usage; adjusted hazard ratio with 95% confidence interval was 0.81 (0.79-0.84) for statin users and 0.81 (0.80-0.83) for non-users in the highest TC quartile, and 0.84 (0.82-0.87) for statin users and 0.85 (0.84-0.86) for non-users in the highest LDL-C quartile (all <i>p</i><0.001).<h4>Conclusion</h4>The paradoxical relationship between lipid levels (TC and LDL-C) and the risk of AF remains consistent in both statin users and non-users.

Item Type:	Article
Uncontrolled Keywords:	Association, Atrial fibrillation, Cholesterol, Lipid
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	18 May 2023 10:43
Last Modified:	18 May 2023 10:43
DOI:	10.12997/jla.2023.12.1.73
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3170487