TY - JOUR
T1 - Evaluation of the Paradoxical Association Between Lipid Levels and Incident Atrial Fibrillation According to Statin Usage
T2 - A Nationwide Cohort Study
AU - Ahn, Hyo-Jeong
AU - Lee, So-Ryoung
AU - Choi, Eue-Keun
AU - Lee, Seung-Woo
AU - Han, Kyung-Do
AU - Kwon, Soonil
AU - Oh, Seil
AU - Lip, Gregory Y. H.
N1 - Copyright © 2023 The Korean Society of Lipid and Atherosclerosis.
PY - 2023/1
Y1 - 2023/1
N2 - Objective: 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. Methods: 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. Results: 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 p<0.001). Conclusion: The paradoxical relationship between lipid levels (TC and LDL-C) and the risk of AF remains consistent in both statin users and non-users.
AB - Objective: 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. Methods: 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. Results: 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 p<0.001). Conclusion: The paradoxical relationship between lipid levels (TC and LDL-C) and the risk of AF remains consistent in both statin users and non-users.
KW - Association
KW - Atrial fibrillation
KW - Cholesterol
KW - Lipi
UR - http://www.scopus.com/inward/record.url?scp=85147157114&partnerID=8YFLogxK
U2 - 10.12997/jla.2023.12.1.73
DO - 10.12997/jla.2023.12.1.73
M3 - Journal article
C2 - 36761066
SN - 2287-2892
VL - 12
SP - 73
EP - 86
JO - Journal of lipid and atherosclerosis
JF - Journal of lipid and atherosclerosis
IS - 1
ER -