Lipid levels in midlife and risk of atrial fibrillation over 3 decades—Experience from the Swedish AMORIS cohort: A cohort study

• DOI: 10.1371/journal.pmed.1004044
• Publication Date: 2022-08-11T17:26:34Z
• Authors: Mozhu Ding; Alexandra Wennberg; Bruna Gigante; Göran Walldius; Niklas Hammar; Karin Modig
• Keywords: Sweden; Apolipoprotein A-I; Cholesterol, HDL; R; Cholesterol, LDL; Lipids; Cohort Studies; Apolipoproteins; Risk Factors; Atrial Fibrillation; Medicine; Humans; Triglycerides; Research Article; Apolipoproteins B

Background The role of cholesterol levels in the development atrial fibrillation (AF) is still controversial. In addition, whether and to what extent apolipoproteins are associated with risk AF rarely studied. this study, we aimed investigate association between blood lipid midlife subsequent new-onset AF. Methods findings This population-based study included 65,136 individuals aged 45 60 years without overt cardiovascular diseases (CVDs) from Swedish Apolipoprotein-Related Mortality Risk (AMORIS) cohort. Lipids were measured 1985 1996, followed until December 31, 2019 for incident (i.e., outcome). Hazard ratios (HRs) 95% confidence intervals (CIs) estimated using Cox regression, adjusting age, sex, socioeconomic status. Over a mean follow-up 24.2 (standard deviation 7.5, range 0.2 35.9), 13,871 (21.3%) cases occurred. Higher total (TC) low-density lipoprotein (LDL-C) statistically significantly lower during first 5 (HR = 0.61, CI: 0.41 0.99, p 0.013; HR 0.64, 0.45 0.92, 0.016), but not thereafter ranging 0.94 [95% 0.89 1.00, 0.038] 0.96 0.77 1.19, > 0.05]). Lower high-density (HDL-C) apolipoprotein A-I (ApoA-I) higher triglycerides (TG)/HDL-C ratio entire 1.13 1.07 < 0.001] 1.53 1.12 2.00, 0.007]). Apolipoprotein B (ApoB)/ApoA-I was risk. observed associations similar among those who developed heart failure (HF)/coronary disease (CHD) did not. main limitations include lack adjustments lifestyle factors high pressure leading potential residual confounding. Conclusions High TC LDL-C AF, present only within measurement thereafter. On contrary, low HDL-C ApoA-I TG/HDL-C an increased over almost 35 follow-up. ApoB/ApoA-I