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Blood lipid levels, lipid-lowering medications, and the incidence of atrial fibrillation: the atherosclerosis risk in communities study.

TitleBlood lipid levels, lipid-lowering medications, and the incidence of atrial fibrillation: the atherosclerosis risk in communities study.
Publication TypeJournal Article
Year of Publication2012
AuthorsNorby FL, Agarwal SK, Maclehose RF, Soliman EZ, Sharrett ARichey, Huxley RR, Konety S, Ballantyne CM
Secondary AuthorsAlonso A
JournalCirc Arrhythm Electrophysiol
Volume5
Issue1
Pagination155-62
Date Published2012 Feb
ISSN1941-3084
KeywordsAtherosclerosis, Atrial Fibrillation, Biomarkers, Female, Follow-Up Studies, Humans, Hypolipidemic Agents, Incidence, Lipids, Male, Middle Aged, Prognosis, Prospective Studies, Risk Assessment, Risk Factors, United States
Abstract

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.

DOI10.1161/CIRCEP.111.966804
Alternate JournalCirc Arrhythm Electrophysiol
PubMed ID22227953
PubMed Central IDPMC3290134
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
N01-HC55021 / HC / NHLBI NIH HHS / United States
09SDG2280087 / / PHS HHS / United States
N01-HC55015 / HC / NHLBI NIH HHS / United States
N01 HC055018 / HC / NHLBI NIH HHS / United States
RC1 HL099452 / HL / NHLBI NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01-HC55022 / HC / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
N01-HC55019 / HC / NHLBI NIH HHS / United States
N01 HC055019 / HC / NHLBI NIH HHS / United States
RC1-HL099452 / HL / NHLBI NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
N01-HC55018 / HC / NHLBI NIH HHS / United States
N01 HC055015 / HC / NHLBI NIH HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
RC1 HL099452-01 / HL / NHLBI NIH HHS / United States
N01-HC55016 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States
N01 HC055016 / HC / NHLBI NIH HHS / United States
N01-HC55020 / HC / NHLBI NIH HHS / United States