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Cai XJ, Tay JCK, Jiang Y, Yeo KK, Wong PEH, Ho KL, Chong DTT, Ti LK, Leong G, Wong K, Ching CK. Non-invasive mid-term electrocardiogram patch monitoring is effective in detecting atrial fibrillation. J Electrocardiol 2023; 81:230-236. [PMID: 37844372 DOI: 10.1016/j.jelectrocard.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/14/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) is a cause of serious morbidity such as stroke. Early detection and treatment of AF is important. Current guidelines recommend screening via opportunistic pulse taking or 12‑lead electrocardiogram. Mid-term ECG patch monitors increases the sensitivity of AF detection. METHODS The Singapore Atrial Fibrillation Study is a prospective multi-centre study aiming to study the incidence of AF in patients with no prior AF and a CHA2DS2-VASc score of at least 1, with the use of a mid-term continuous ECG monitoring device (Spyder ECG). Consecutive patients from both inpatient and outpatient settings were recruited from 3 major hospitals from May 2016 to December 2019. RESULTS Three hundred and fifty-five patients were monitored. 6 patients (1.7%) were diagnosed with AF. There were no significant differences in total duration of monitoring between the AF and non-AF group (6.39 ± 3.19 vs 5.42 ± 2.46 days, p = 0.340). Patients with newly detected AF were more likely to have palpitations (50.0% vs 11.8%, p = 0.027). Half of the patients (n = 3, 50.0%) were diagnosed on the first day of monitoring and the rest were diagnosed after 24 h. On univariate analysis, only hyperlipidemia was associated with reduced odds of being diagnosed with AF (OR HR 0.08 CI 0.01-0.74, p = 0.025). In a group of 128 patients who underwent coronary artery bypass grafting and had post-operative ECG monitoring, 9 patients (7.0%) were diagnosed with post-operative AF. CONCLUSIONS The use of non-invasive mid-term patch-based ECG monitoring is an effective modality for AF screening.
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Affiliation(s)
- Xinzhe James Cai
- Department of Cardiology, National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore.
| | - Julian Cheong Kiat Tay
- Department of Cardiology, National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore
| | - Yilin Jiang
- Department of Cardiology, National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore
| | - Khung Keong Yeo
- Department of Cardiology, National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore; Duke-NUS Medical School, Singapore 8 College Road, 169857, Singapore
| | - Philip En Hou Wong
- Department of Cardiology, National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore
| | - Kah Leng Ho
- Department of Cardiology, National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore
| | - Daniel Thuan Tee Chong
- Department of Cardiology, National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore
| | - Lian Kah Ti
- Department of Anaesthesia, National University Hospital, 5 Lower Kent Ridge Road, 119074, Singapore
| | - Gerard Leong
- Department of Cardiology, Changi General Hospital, 2 Simei Steet 3, 529889, Singapore
| | - Kelvin Wong
- Department of Cardiology, Changi General Hospital, 2 Simei Steet 3, 529889, Singapore
| | - Chi Keong Ching
- Department of Cardiology, National Heart Centre Singapore, 5 Hospital Drive, 169609, Singapore
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Wang TY, Chang WL, Wei CY, Liu CH, Tzeng RC, Chiu PY. Cholesterol Paradox in Older People with Type 2 Diabetes Mellitus Regardless of Lipid-Lowering Drug Use: A Cross-Sectional Cohort Study. Nutrients 2023; 15:3270. [PMID: 37513689 PMCID: PMC10384075 DOI: 10.3390/nu15143270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Lipid-lowering drugs (LLDs) have protective effects against coronary artery disease (CAD) and cerebrovascular disease (CVD); however, a paradoxical association with cholesterol has been identified in several diseases, such as diabetes, dementia, and atrial fibrillation. We aimed to analyze the association between LLDs and cholesterol levels in older adults with type 2 diabetes mellitus (T2DM). This cross-sectional study enrolled consecutive patients aged ≥50 years from three centers in Taiwan. A multiple logistic regression model was used, and odds ratios (ORs) for different levels of total cholesterol (TC) or low-density-lipoprotein cholesterol (LDL-C) compared with the highest level were adjusted for age, triglyceride level, sex, comorbidities, and medications. Among the 3688 participants, 572 with and 676 without T2DM used LLDs. After adjusting for age and sex, the non-T2DM group demonstrated better medical conditions, cognition, and daily function than the T2DM group, regardless of LLD use. Compared to the highest TC level (≥240 mg/dL), ORs were significantly increased as TC levels decreased. A similar pattern of T2DM prevalence was observed in LDL-C levels. Older people with T2DM demonstrated low cognitive and daily functions. Significantly reduced TC and LDL levels were associated with a higher T2DM prevalence in older adults regardless of LLD use. T2DM was associated with impaired cognitive and daily functioning. A higher prevalence of T2DM in older people with low cholesterol levels raises doubt surrounding cognition and daily function being jeopardized when the "lower is better" strategy is applied for the secondary prevention of CAD or CVD.
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Affiliation(s)
- Tzu-Yuan Wang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, China Medical University Hospital, Taichung 404, Taiwan
| | - Wei-Lun Chang
- Department of Neurology, Show Chwan Memorial Hospital, Changhua 500, Taiwan
| | - Cheng-Yu Wei
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei 111, Taiwan
- Department of Neurology, Chang Bing Show Chwan Memorial Hospital, Changhua 505, Taiwan
| | - Chung-Hsiang Liu
- Division of Department of Neurology, China Medical University Hospital, Taichung 404, Taiwan
| | - Ray-Chang Tzeng
- Department of Neurology, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan 701, Taiwan
| | - Pai-Yi Chiu
- Department of Neurology, Show Chwan Memorial Hospital, Changhua 500, Taiwan
- Department of Applied Mathematics, Tunghai University, Taichung 407, Taiwan
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Ahn HJ, Lee SR, Choi EK, Lee SW, Han KD, Kwon S, Oh S, Lip GYH. Evaluation of the Paradoxical Association Between Lipid Levels and Incident Atrial Fibrillation According to Statin Usage: A Nationwide Cohort Study. J Lipid Atheroscler 2023; 12:73-86. [PMID: 36761066 PMCID: PMC9884554 DOI: 10.12997/jla.2023.12.1.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 10/14/2022] [Accepted: 11/17/2022] [Indexed: 01/26/2023] Open
Abstract
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.
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Affiliation(s)
- Hyo-Jeong Ahn
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - So-Ryoung Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Eue-Keun Choi
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Woo Lee
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Soonil Kwon
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seil Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Gregory Y. H. Lip
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Chest & Heart Hospital, Liverpool, United Kingdom.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Zhao D, Jiao H, Zhong X, Wang W, Li L. The association between serum albumin levels and related metabolic factors and atrial fibrillation: A retrospective study. Medicine (Baltimore) 2022; 101:e31581. [PMID: 36343084 PMCID: PMC9646583 DOI: 10.1097/md.0000000000031581] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The association between serum albumin (ALB) and cardiovascular events has been well established, but the relationship with atrial fibrillation (AF) remains controversial. This study aims to evaluate the association between ALB and AF in a Chinese population. We reviewed the medical records of 2000 hospitalized patients, 1000 patients with AF were included in the AF group, and 1000 age- and sex-matched patients with sinus rhythm and no history of AF were included in the control group. The T test or chi-square test were conducted to analyze clinical baseline data. Logistic regression analysis was conducted to assess the relationship between AF and ALB. The interrelationships of ALB were analyzed by Pearson correlation analyses. The appropriate cutoff value of ALB for AF was analyzed by receiver operating characteristic curves. ALB levels were lower in the AF group than in the control group (P < .05). After multivariable adjustment, ALB was independently negatively associated with AF (odds ratio = 0.935, 95% confidence interval: 0.905-0.965, P < .05). ALB levels were positively correlated with serum globulin, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, serum apolipoprotein A1, and serum apolipoprotein B levels (P < .05), but negatively correlated with serum creatinine levels (P < .05). The optimal cutoff value of ALB for predicting AF was 37.25 g/L, the sensitivity was 78.0%, and the specificity was 4.6%. Low ALB level is independently associated with AF. Since the current study design cannot establish causalities, further prospective cohort studies are needed to determine this finding.
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Affiliation(s)
- Dongsheng Zhao
- First School of Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Huachen Jiao
- Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
- * Correspondence: Huachen Jiao, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Room 101, Unit 3, Building 1, No. 125, Huanshan Road, Lixia District, Jinan, Shandong 250014, PR China (e-mail: )
| | - Xia Zhong
- First School of Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Wei Wang
- Department of Endocrinology, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China
| | - Lianlian Li
- First School of Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
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Santos IS, Lotufo PA, Goulart AC, Brant LCC, Pinto MM, Pereira AC, Barreto SM, Ribeiro ALP, Thomas GN, Lip GYH, Bensenor IM. Cardiovascular Health and Atrial Fibrillation or Flutter: A Cross-Sectional Study from ELSA-Brasil. Arq Bras Cardiol 2022; 119:S0066-782X2022005016205. [PMID: 36169453 PMCID: PMC9750207 DOI: 10.36660/abc.20210970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 03/13/2022] [Accepted: 06/01/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The association between ideal cardiovascular health (ICVH) status and atrial fibrillation or flutter (AFF) diagnosis has been less studied compared to other cardiovascular diseases. OBJECTIVE To analyze the association between AFF diagnosis and ICVH metrics and scores in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS This study analyzed data from 13,141 participants with complete data. Electrocardiographic tracings were coded according to the Minnesota Coding System, in a centralized reading center. ICVH metrics (diet, physical activity, body mass index, smoking, blood pressure, fasting plasma glucose, and total cholesterol) and scores were calculated as proposed by the American Heart Association. Crude and adjusted binary logistic regression models were built to analyze the association of ICVH metrics and scores with AFF diagnosis. Significance level was set at 0.05. RESULTS The sample had a median age of 55 years and 54.4% were women. In adjusted models, ICVH scores were not significantly associated with prevalent AFF diagnosis (odds ratio [OR]:0.96; 95% confidence interval [95% CI]:0.80-1.16; p=0.70). Ideal blood pressure (OR:0.33; 95% CI:0.15-0.74; p=0.007) and total cholesterol (OR:1.88; 95% CI:1.19-2.98; p=0.007) profiles were significantly associated with AFF diagnosis. CONCLUSIONS No significant associations were identified between global ICVH scores and AFF diagnosis after multivariable adjustment in our analyses, at least partially due to the antagonistic associations of AFF with blood pressure and total cholesterol ICVH metrics. Our results suggest that estimating the prevention of AFF burden using global ICVH scores may not be adequate, and ICVH metrics should be considered in separate.
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Affiliation(s)
- Itamar S. Santos
- Departamento de Clínica MédicaFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrasil Departamento de Clínica Médica da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP – Brasil
- Centro de Pesquisa Clínica e EpidemiológicaHospital UniversitárioUniversidade de São PauloSão PauloSPBrasil Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo , São Paulo , SP – Brasil
| | - Paulo A. Lotufo
- Departamento de Clínica MédicaFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrasil Departamento de Clínica Médica da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP – Brasil
- Centro de Pesquisa Clínica e EpidemiológicaHospital UniversitárioUniversidade de São PauloSão PauloSPBrasil Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo , São Paulo , SP – Brasil
| | - Alessandra C. Goulart
- Centro de Pesquisa Clínica e EpidemiológicaHospital UniversitárioUniversidade de São PauloSão PauloSPBrasil Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo , São Paulo , SP – Brasil
| | - Luisa C. C. Brant
- Departamento de Clínica MédicaFaculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Departamento de Clínica Médica da Faculdade de Medicina da Universidade Federal de Minas Gerais , Belo Horizonte , MG – Brasil
| | - Marcelo M Pinto
- Programa de Pós-Graduação em Infectologia e Medicina TropicalFaculdade de MedicinaUniversidade Federal de Minas Gerais,Belo HorizonteMGBrasil Programa de Pós-Graduação em Infectologia e Medicina Tropical da Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte , MG – Brasil
| | - Alexandre C. Pereira
- Hospital das ClínicasFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrasil Laboratório de Genética e Cardiologia Molecular do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP – Brasil
| | - Sandhi M. Barreto
- Departamento de Medicina Preventiva e SocialFaculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Departamento de Medicina Preventiva e Social da Faculdade de Medicina da Universidade Federal de Minas Gerais , Belo Horizonte , MG – Brasil
| | - Antonio L. P. Ribeiro
- Departamento de Clínica MédicaFaculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Departamento de Clínica Médica da Faculdade de Medicina da Universidade Federal de Minas Gerais , Belo Horizonte , MG – Brasil
| | - G Neil Thomas
- Institute of Applied Health ResearchCollege of Medical and Dental SciencesUniversity of BirminghamBirminghamReino Unido Institute of Applied Health Research , College of Medical and Dental Sciences , University of Birmingham , Birmingham – Reino Unido
| | - Gregory Y. H. Lip
- Chest Hospital and Aalborg Thrombosis Research UnitDepartment of Clinical MedicineAalborg UniversityLiverpoolReino Unido Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital and Aalborg Thrombosis Research Unit , Department of Clinical Medicine , Aalborg University , Liverpool – Reino Unido
| | - Isabela M. Bensenor
- Departamento de Clínica MédicaFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrasil Departamento de Clínica Médica da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP – Brasil
- Centro de Pesquisa Clínica e EpidemiológicaHospital UniversitárioUniversidade de São PauloSão PauloSPBrasil Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo , São Paulo , SP – Brasil
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Zhong X, Jiao H, Zhao D, Teng J. Association between serum albumin levels and paroxysmal atrial fibrillation by gender in a Chinese population: a case–control study. BMC Cardiovasc Disord 2022; 22:387. [PMID: 36031606 PMCID: PMC9420273 DOI: 10.1186/s12872-022-02813-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/08/2022] [Indexed: 11/29/2022] Open
Abstract
Background Hypoalbuminemia is linked to the emergence of cardiovascular events. However, there is an unclear association between serum albumin (ALB) and gender in paroxysmal AF patients. This retrospective study aimed to explore the association between ALB levels and paroxysmal AF by gender in a Chinese population. Methods This study included patients with paroxysmal AF who were hospitalized consecutively in China from January 2019 to September 2021. Controls with sinus rhythm and without paroxysmal AF were matched (2:1) to cases by gender and age. Pearson correlation analysis was used to study the correlation between ALB and blood lipid profiles, multivariate regression models were performed to investigate the association between ALB and paroxysmal AF. Results There were 305 patients with paroxysmal AF and 610 patients with controls included in this study. Low ALB in male with AF patients were significantly associated with paroxysmal AF (OR = 0.889, 95% CI 0.832–0.950). ALB was positively correlated with triglyceride (TG) (r = 0.212, p < 0.001), total cholesterol (TC) (r = 0.381, p = 0.002), low-density lipoprotein cholesterol (LDL-C) (r = 0.263, p < 0.001), and high-density lipoprotein cholesterol (HDL-C) (r = 0.329, p < 0.001). Conclusion Low ALB in male patients is significantly associated with paroxysmal AF in a Chinese population. Monitoring for hypoalbuminemia in men might help reduce the incidence of paroxysmal AF.
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7
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Liu L, Liu X, Ding X, Chen H, Li W, Li H. Lipid Levels and New-Onset Atrial Fibrillation in Patients with Acute Myocardial Infarction. J Atheroscler Thromb 2022; 30:515-530. [PMID: 35871559 PMCID: PMC10164594 DOI: 10.5551/jat.63574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM In acute myocardial fraction (AMI) patients, the association between lipid parameters and new-onset atrial fibrillation (NOAF) remains unclear due to limited evidence. METHODS A total of 4282 participants free from atrial fibrillation (AF) at baseline were identified in Beijing Friendship Hospital. Fasting levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured at baseline. The study population was stratified based on tertiles of lipid profile and lipid ratios. Incidence of NOAF was observed at the follow-up visits. The associations between different lipid parameters and the incidence of NOAF were assessed by multivariate Cox regression analysis. RESULTS Over a median follow-up period of 42.0 months (IQR: 18.7, 67.3 months), 3.1% (N=132) AMI patients developed NOAF. After multivariable adjustment, higher TC (hazard ratios (HR): 0.205, 95% confidence intervals (CI): 0.061-0.696) levels were inversely associated with NOAF development. However, higher HDL-C (HR: 1.892, 95% CI: 1.133-3.159) levels were positively associated with NOAF development. LDL-C levels, TG levels, non-HDL-C levels, and lipid ratios showed no association with NOAF development. CONCLUSION TC levels were inversely associated with incidence of NOAF; this was mainly reflected in the subgroups of male gender and older patients (65 years or older). HDL-C levels were positively associated with incidence of NOAF; this was mainly reflected in the subgroups of male gender and younger patients (age <65 years). There was no significant association of NOAF with LDL-C, TG, or non-HDL-C levels.
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Affiliation(s)
- Lei Liu
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University
| | - Xiaoyan Liu
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University
| | - Xiaosong Ding
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University
| | - Hui Chen
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University
| | - Weiping Li
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University.,Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease
| | - Hongwei Li
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University.,Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease.,Department of Geriatrics, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University
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Association between serum apolipoprotein B and atrial fibrillation: a case-control study. Sci Rep 2022; 12:9597. [PMID: 35688870 PMCID: PMC9187736 DOI: 10.1038/s41598-022-13773-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 05/27/2022] [Indexed: 11/08/2022] Open
Abstract
The relationship between apolipoprotein B (APOB) and atrial fibrillation (AF) is less well-known. We aimed to investigate the association between APOB and AF by gender. We conducted a case-control study including 1913 consecutive hospitalized patients to analyze the association between APOB and AF. 950 AF patients and 963 age-, sex-matched non-AF patients with sinus rhythm were evaluated. T-test, Mann-Whitney test, ANOVA, and Chi-square analysis were performed to analyze baseline data and intergroup comparisons. Pearson's correlation tests or Spearman correlation tests were performed to determine the interrelationships. Multiple regression analysis was performed to adjust for covariables. The receiver operator characteristic (ROC) curve was constructed to examine the performance of APOB. AF patients had lower APOB (P < 0.001) and an independent negative association between APOB and AF in both genders adjusting for confounding factors (OR 0.121, 95% CI 0.067-0.220, P < 0.001), regardless of statin use. APOB was positively correlated with total cholesterol (TC) (r = 0.529, p < 0.001), low-density lipoprotein cholesterol (LDL-C) (r = 0.545, p < 0.001), apolipoprotein A1 (APOA1) (r = 0.083, p < 0.001), and albumin (ALB) (r = 0.134, p < 0.001). ROC curve analysis showed that APOB level = 0.895 g/L was the most optimal cut-off value, the area under the ROC curve was 0.722. This study shows a protective association of APOB with AF in men and women. It implies APOB may be a potential biomarker for AF with a promising cut-off point of 0.895 g/L and may involve initiating and maintaining AF along with several metabolic factors.
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Lifestyle Modification and Atrial Fibrillation: Critical Care for Successful Ablation. J Clin Med 2022; 11:jcm11092660. [PMID: 35566788 PMCID: PMC9099891 DOI: 10.3390/jcm11092660] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 02/07/2023] Open
Abstract
Management of atrial fibrillation (AF) requires a comprehensive approach due to the limited success of medical or procedural approaches in isolation. Multiple modifiable risk factors contribute to the development and progression of the underlying substrate, with a heightened risk of progression evident with inadequate risk factor management. With increased mortality, stroke, heart failure and healthcare utilisation linked to AF, international guidelines now strongly support risk factor modification as a critical pillar of AF care due to evidence demonstrating the efficacy of this approach. Effective lifestyle management is key to arrest and reverse the progression of AF, in addition to increasing the likelihood of freedom from arrhythmia following catheter ablation.
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Elimination of Vitamin D Signaling Causes Increased Mortality in a Model of Overactivation of the Insulin Receptor: Role of Lipid Metabolism. Nutrients 2022; 14:nu14071516. [PMID: 35406129 PMCID: PMC9002971 DOI: 10.3390/nu14071516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/01/2022] [Accepted: 04/03/2022] [Indexed: 11/17/2022] Open
Abstract
Vitamin D (VD) deficiency has been associated with cancer and diabetes. Insulin signaling through the insulin receptor (IR) stimulates cellular responses by activating the PI3K/AKT pathway. PTEN is a tumor suppressor and a negative regulator of the pathway. Its absence enhances insulin signaling leading to hypoglycemia, a dangerous complication found after insulin overdose. We analyzed the effect of VD signaling in a model of overactivation of the IR. We generated inducible double KO (DKO) mice for the VD receptor (VDR) and PTEN. DKO mice showed severe hypoglycemia, lower total cholesterol and increased mortality. No macroscopic tumors were detected. Analysis of the glucose metabolism did not show clear differences that would explain the increased mortality. Glucose supplementation, either systemically or directly into the brain, did not enhance DKO survival. Lipidic liver metabolism was altered as there was a delay in the activation of genes related to β-oxidation and a decrease in lipogenesis in DKO mice. High-fat diet administration in DKO significantly improved its life span. Lack of vitamin D signaling increases mortality in a model of overactivation of the IR by impairing lipid metabolism. Clinically, these results reveal the importance of adequate Vitamin D levels in T1D patients.
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Diab A, Valenzuela Ripoll C, Guo Z, Javaheri A. HDL Composition, Heart Failure, and Its Comorbidities. Front Cardiovasc Med 2022; 9:846990. [PMID: 35350538 PMCID: PMC8958020 DOI: 10.3389/fcvm.2022.846990] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 02/09/2022] [Indexed: 12/24/2022] Open
Abstract
Although research on high-density lipoprotein (HDL) has historically focused on atherosclerotic coronary disease, there exists untapped potential of HDL biology for the treatment of heart failure. Anti-oxidant, anti-inflammatory, and endothelial protective properties of HDL could impact heart failure pathogenesis. HDL-associated proteins such as apolipoprotein A-I and M may have significant therapeutic effects on the myocardium, in part by modulating signal transduction pathways and sphingosine-1-phosphate biology. Furthermore, because heart failure is a complex syndrome characterized by multiple comorbidities, there are complex interactions between heart failure, its comorbidities, and lipoprotein homeostatic mechanisms. In this review, we will discuss the effects of heart failure and associated comorbidities on HDL, explore potential cardioprotective properties of HDL, and review novel HDL therapeutic targets in heart failure.
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Zhu T, Chen M, Wang M, Wang Z, Wang S, Hu H, Ma K, Jiang H. Association between adiponectin-to-leptin ratio and heart rate variability in new-onset paroxysmal atrial fibrillation: A retrospective cohort study. Ann Noninvasive Electrocardiol 2021; 27:e12896. [PMID: 34599782 PMCID: PMC8916558 DOI: 10.1111/anec.12896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 12/20/2022] Open
Abstract
Background The adiponectin‐to‐leptin (A/L) ratio has been identified as a potential surrogate biomarker for metabolic disorders. However, it remains unknown whether the serum A/L ratio is associated with heart rate variability in paroxysmal atrial fibrillation (AF). Methods For this retrospective study, we included consecutive patients who underwent 24‐h long‐range electrocardiogram examination in our center for paroxysmal AF. The results of echocardiography, heart rate variability tests, and blood tests were also retrieved. Multivariate line regression analysis was performed to evaluate identify factors independently associated with heart rate variability. Results Among the 85 included patients with paroxysmal AF, the median A/L ratio was 1.71. Univariate analysis indicated that patients with a low A/L ratio (<1.71, n = 42) had a lower high‐frequency (HF) power and a higher hs‐CRP level, low‐frequency (LF) power, and LF/HF ratio than those with a high A/L ratio (≥1.71, n = 43). Multivariate linear regression analysis showed that the serum leptin concentration was independently and positively associated with LF (β = 0.175, p = .028), while the serum adiponectin concentration was independently and positively associated with HF (β = 0.321, p = .001). Moreover, the A/L ratio was independently and negatively associated with the LF/HF ratio (β = −0.276, p = .007). Conclusions The A/L ratio was independently and negatively associated with the LF/HF ratio in patients with new‐onset paroxysmal AF.
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Affiliation(s)
- Tongjian Zhu
- Hubei Key Laboratory of Cardiology, Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Wuhan, China.,Department of Cardiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Mingxian Chen
- Department of Cardiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Meng Wang
- Hubei Key Laboratory of Cardiology, Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Wuhan, China
| | - Zhuo Wang
- Hubei Key Laboratory of Cardiology, Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Wuhan, China
| | - Songyun Wang
- Hubei Key Laboratory of Cardiology, Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Wuhan, China
| | - He Hu
- Department of Cardiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Kezhong Ma
- Department of Cardiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Hong Jiang
- Hubei Key Laboratory of Cardiology, Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Wuhan, China
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Comprehensive Use of Routine Clinical Parameters to Identify Patients at Risk of New-Onset Atrial Fibrillation in Acute Myocardial Infarction. J Clin Med 2021; 10:jcm10163622. [PMID: 34441918 PMCID: PMC8397121 DOI: 10.3390/jcm10163622] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/09/2021] [Accepted: 08/14/2021] [Indexed: 12/11/2022] Open
Abstract
(1) Background: New-onset atrial fibrillation (NOAF) is a significant complication of acute myocardial infarction (AMI). Our study aimed to investigate whether routinely checked clinical parameters aid in NOAF identification in modernly treated AMI patients. (2) Patients and methods: Patients admitted consecutively within 2017 and 2018 to the University Clinical Centre in Gdańsk (Poland) with AMI diagnosis (necrosis evidence in a clinical setting consistent with acute myocardial ischemia) were enrolled. Medical history and clinical parameters were checked during NOAF prediction. (3) Results: NOAF was diagnosed in 106 (11%) of 954 patients and was significantly associated with in-hospital mortality (OR 4.54, 95% CI 2.50-8.33, p < 0.001). Age, B-type natriuretic peptide (BNP), C-reactive protein (CRP), high-sensitivity troponin I, total cholesterol, low-density lipoprotein cholesterol, potassium, hemoglobin, leucocytes, neutrophil/lymphocyte ratio, left atrium size, and left ventricular ejection fraction (LVEF) were associated with NOAF in the univariate logistic analysis, whereas age ≥ 66 yo, BNP ≥ 340 pg/mL, CRP ≥ 7.7 mg/L, and LVEF ≤ 44% were associated with NOAF in the multivariate analysis. (4) Conclusions: NOAF is a multifactorial, significant complication of AMI, leading to a worse prognosis. Simple, routinely checked clinical parameters could be helpful indices of this arrhythmia in current invasively treated patients with AMI.
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Affiliation(s)
- Itamar S Santos
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Isabela M Bensenor
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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15
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The Impact of Hypertension and Atrial Fibrillation on Cognitive Decline and Subclinical Atherosclerosis. Brain Sci 2021; 11:brainsci11060752. [PMID: 34204086 PMCID: PMC8228320 DOI: 10.3390/brainsci11060752] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Assessment of cognitive impairment and the presence of subclinical atherosclerosis are very important especially in patients with cardiovascular risk factors. Methods: We included 155 hypertensive patients (84 with AF versus 71 without AF) to identify the premature cognitive impairment, the earliest signs of subclinical atherosclerosis and onset of myocardial dysfunction and to evaluate the type of anticoagulation used, the importance of CHA₂DS₂-VASc score (</>3), age (</>65 years) in hypertensive patients with AF. Results: Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), Left Ventricular Ejection Fraction (LVEF) were significantly decreased, and Activities of Daily Living Score (ADL), Geriatric Depression Scale(GDS-15), and intima–media thickness (IMT) were significantly increased in hypertensive patients with AF vs. without AF (p < 0.05). MMSE was significantly decreased, ADL and IMT were significant increased in patients with AF and CHA₂DS₂-VASc>3 and non-vitamin K antagonists oral anticoagulants therapy (NOACs)(p < 0.05). Patients with age >65 with AF had higher rates of cognitive impairment (MMSE significant decrease) and a larger IMT (significant increase) versus patients with AF and age <65 (p < 0.05). Conclusions: Cognitive impairment is encountered in hypertensive patients having AF. Our conclusions suggest a direct link between cognitive impairment, depression, hypertension, AF, age, CHA₂DS₂-VASc score, type of anticoagulants used, LVEF, cognitive parameters, and IMT. We acknowledge the importance of identifying and preventing cognitive changes.
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16
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Jiang Q, Qin D, Yang L, Lin Y, Zhai L, Zhang Y, Yang G, Wang K, Tong D, Li X, Chen Z, Huang K, Yu T, Xiang X, Cui C, Cai C, Shi J, Li M, Chen M. Causal effects of plasma lipids on the risk of atrial fibrillation: A multivariable mendelian randomization study. Nutr Metab Cardiovasc Dis 2021; 31:1569-1578. [PMID: 33814236 DOI: 10.1016/j.numecd.2021.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/15/2021] [Accepted: 02/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Observational studies have suggested that plasma lipids contribute substantially to cardiovascular disease, but "cholesterol paradox" in atrial fibrillation (AF) remains. We sought to investigate the causal effects of lipid profiles on the risk of AF. METHODS AND RESULTS Two-sample Mendelian randomization (MR) framework was implemented to examine the causality of association. Summary estimations of genetic variants associated with low density lipoprotein (LDL)-cholesterol, high density lipoprotein (HDL)-cholesterol, total cholesterol, triglycerides, lipoprotein-a [Lp(a)], apolipoprotein A1 (ApoA 1), and apolipoprotein B (ApoB) were 81, 99, 96, 61, 30, 10, and 23 single nucleotide polymorphisms, respectively. Genetic association with AF were retrieved from a genome-wide association study that included 1,030,836 individuals. The complications for AF were predefined as cardioembolic stroke (CES) and heart failure (HF). In the multivariable MR, the odds ratios for AF per standard deviation (SD) increase were 1.030 (95% confidence interval (CI) 0.979-1.083; P = 0.257) for LDL-cholesterol, 0.986 (95% CI 0.931-1.044; P = 0.622) for HDL-cholesterol, 0.965 (95% CI 0.896-1.041; P = 0.359) for triglycerides, 1.001 (95% CI 1.000-1.003; P = 0.023) for Lp(a), 1.017 (95% CI 0.966-1.070; P = 0.518) for ApoA1, and 1.002 (95% CI 0.963-1.043; P = 0.923) for ApoB. There was no evidence that other lipid components were causally associated with AF, CES, or HF, other than for a marginal association between triglycerides and HF. CONCLUSIONS This MR study provides robust evidence that high Lp(a) increases the risk of AF, suggesting that interventions targeting Lp(a) may contribute to the primary prevention of AF.
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Affiliation(s)
- Qi Jiang
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Dingxin Qin
- Cardiovascular Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Ling Yang
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yongping Lin
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lishang Zhai
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yuli Zhang
- Department of Pharmacy, The Third People's Hospital of Changzhou, Changzhou, China
| | - Gang Yang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Kexin Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Debing Tong
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xintao Li
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Zijun Chen
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Kai Huang
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Tianhong Yu
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xue Xiang
- Department of Cardiology, The Seventh People's Hospital of Changzhou, Changzhou, China
| | - Chang Cui
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Cheng Cai
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiaojiao Shi
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Mingfang Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Minglong Chen
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Wańkowicz P, Nowacki P, Gołąb-Janowska M. Atrial fibrillation risk factors in patients with ischemic stroke. Arch Med Sci 2021; 17:19-24. [PMID: 33488851 PMCID: PMC7811312 DOI: 10.5114/aoms.2019.84212] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 02/27/2019] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Atrial fibrillation (AF) is the most common heart arrhythmia. The condition is known to increase the risk of ischemic stroke (IS). Classical risk factors for the development of AF include advanced age, hypertension, diabetes mellitus, coronary heart disease and lipid metabolism disorders. Importantly, these are also recognized risk factors for ischemic stroke. Therefore, the purpose of this study was to investigate AF risk factors in patients with IS. MATERIAL AND METHODS This is single-centre retrospective study which included 696 patients with acute ischemic stroke and nonvalvular atrial fibrillation and 1678 patients with acute ischemic stroke without atrial fibrillation. RESULTS In this study we found - based on a univariable and multivariable logistic regression model - that compared to the patients with IS without AF, the group of patients which suffered from IS with nonvalvular atrial fibrillation (NVAF) had a higher proportion of patients who smoked cigarettes (OR = 15.742, p < 0.01; OR = 41.1, p < 0.01), had hypertension (OR = 5.161, p < 0.01; OR = 5.666, p < 0.01), history of previous stroke (OR = 3.951, p < 0.01; OR = 4.792, p < 0.01), dyslipidemia (OR = 2.312, p < 0.01; OR = 1.592, p < 0.01), coronary heart disease (OR = 2.306, p < 0.01; OR = 1.988, p < 0.01), a greater proportion of female patients (OR = 1.717, p < 0.01; OR = 2.095, p < 0.01), higher incidence of diabetes mellitus (OR = 1.341, p < 0.01; OR = 1.261, p = 0.106) and more patients in old age (OR = 1.084, p < 0.01; OR = 1.101, p < 0.01). CONCLUSIONS Our study demonstrates a need for thorough and systematic monitoring of post-ischemic stroke patients in whom AF has not been detected and who display other important risk factors. Regardless of the stroke, these factors may be responsible for development of AF.
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Affiliation(s)
- Paweł Wańkowicz
- Department of Neurology, Pomeranian Medical University, Szczecin, Poland
| | - Przemysław Nowacki
- Department of Neurology, Pomeranian Medical University, Szczecin, Poland
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Anzai T, Grandinetti A, Katz AR, Hurwitz EL, Wu YY, Masaki K. Paradoxical association between atrial fibrillation/flutter and high cholesterol over age 75 years: The Kuakini Honolulu Heart Program and Honolulu-Asia Aging Study. J Electrocardiol 2020; 65:37-44. [PMID: 33482619 DOI: 10.1016/j.jelectrocard.2020.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/06/2020] [Accepted: 12/14/2020] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Several studies have indicated high cholesterol is paradoxically associated with low prevalence of atrial fibrillation/flutter (AF). However, the etiology is uncertain. One potential explanation might be the confounding effect of age exemplifying prevalence-incidence (Neyman's) bias. However, this bias has not often been discussed in depth in the literature. Therefore, we conducted a cross-sectional analysis to test the hypothesis that there is a paradoxical association between lipid profile and AF prevalence. METHODS This is a cross-sectional study design, using data from the Kuakini Honolulu Heart Program. Participants were 3741 Japanese-American men between 71 and 93 years old living in Hawaii. Serum total cholesterol (TC) level was measured and categorized into quartiles. AF was diagnosed by 12‑lead Electrocardiogram. We categorized age into quartiles (71-74, 75-77, 78-80 and 81+ years). RESULTS We observed opposite associations between AF and TC among different age groups. For participants age ≥75, higher TC levels were paradoxically associated with lower prevalence of AF after multivariable adjustment, i.e. the odds ratios of AF comparing the highest TC quartile with the lowest TC quartile for age 75-77, 78-80 and 81+ years were 0.17 (95% confidence interval [CI], 0.06-0.52), 0.28 (95% CI, 0.07-1.09) and 0.14 (95% CI, 0.03-0.62), respectively. Conversely, for those who were 71-74 years old, the odds ratio of AF was 2.09 (95% CI, 0.76-5.75) between the highest and the lowest TC quartiles. CONCLUSIONS There is a paradoxical association of TC with AF in Japanese-American men age ≥75, but not <75 years. The paradox might be explained by Neyman's bias.
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Affiliation(s)
- Tagayasu Anzai
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East-West Road, Honolulu, HI, USA.
| | - Andrew Grandinetti
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East-West Road, Honolulu, HI, USA.
| | - Alan R Katz
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East-West Road, Honolulu, HI, USA.
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East-West Road, Honolulu, HI, USA.
| | - Yan Yan Wu
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East-West Road, Honolulu, HI, USA.
| | - Kamal Masaki
- Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawai'i at Mānoa, 347 N Kuakini St, Honolulu, HI, USA; Kuakini Medical Center, 347 N Kuakini St, Honolulu, HI, USA.
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19
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P wave dispersion and ventricular repolarization changes in children with familial hypercholesterolemia. Cardiol Young 2020; 30:1643-1648. [PMID: 33161938 DOI: 10.1017/s1047951120003765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Familial hypercholesterolemia is a genetic disease with plasma total cholesterol especially low-density lipoprotein-cholesterol elevation. In this study, we aimed to examine the changes in the electrocardiographies of children with familial hypercholesterolemia. MATERIALS AND METHODS Electrocardiography of 85 patients with a diagnosis of familial hypercholesterolemia, followed up from the Pediatric Metabolism and Pediatric Cardiology outpatient clinic was examined. Electrocardiography of 83 children from the control group who did not have hypercholesterolemia in a similar gender and age range were examined. Heart rate, P wave, PR interval, P wave dispersion, QRS wave, QT interval, corrected QT (calculated with Bazett formula), Tpeak-end interval, QT dispersion, corrected QT dispersion, JT interval, corrected JT (calculated with Bazett formula) were statistically compared. RESULTS P wave, PR interval, and P wave dispersion values were significantly higher (p < 0.05) in the children with familial hypercholesterolemia. Corrected QT, QT dispersion, corrected QT dispersion, JT interval, corrected JT, Tpeak-end interval were significantly higher than the control group (p < 0.05) in children with familial hypercholesterolemia. These statistical differences in electrocardiography parameters support the risk of atrial and/or ventricular arrhythmia in children with familial hypercholesterolemia. CONCLUSION We found that high total cholesterol and low-density lipoprotein-cholesterol variables are associated with an increased risk of cardiac atrial and/or ventricular arrhythmia. The findings suggest that total cholesterol and low-density lipoprotein-cholesterol variability can be used as a new marker for the risk of cardiac arrhythmia. In this case, decreasing total cholesterol and low-density lipoprotein-cholesterol variability below certain thresholds may decrease the risk of cardiac arrhythmia.
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Harrison SL, Lane DA, Banach M, Mastej M, Kasperczyk S, Jóźwiak JJ, Lip GY, Al-Shaer B, Andrusewicz W, Andrzejczuk-Rosa M, Anusz-Gaszewska E, Bagińska A, Balawajder P, Bańka G, Barańska-Skubisz E, Barbara Przyczyna B, Bartkowiak S, Bartodziej J, Bartosiewicz M, Basałyga M, Batyra A, Bąk A, Bednarz M, Bejnar K, Bernacki W, Betiuk-Kwiatkowska M, Biegaj S, Bień M, Bilski W, Biłogan M, Biruta-Pawłowska G, Biskup A, Błaszczyk B, Błaszczyk H, Błońska-Jankowska T, Bogacka-Gancarczyk B, Bojanowska M, Bonda E, Borowik-Skwarek J, Borowska J, Bruckner J, Brzostek J, Brzuchacz M, Budzyńska M, Bulzacka-Fugiel I, Bulzak J, Bunikowski K, Cebulska A, Celka T, Cempel-Nowak E, Chechliński W, Chludzińska A, Chmiel D, Chmielewska M, Cichy M, Ciemięga A, Ciepluch A, Cieszyńska I, Czajka B, Czapla B, Czerner M, Czerwińska B, Czuryszkiewicz W, Daleka E, Dawid Z, Dąbrowska M, Dąbrowska R, Dąbrowski D, Dąbrowski M, Demczyszyn K, Dębowska-Serwińska A, Dmochowski J, Dobrzecka-Kiwior J, Dolanowska E, Dolanowski H, Dołek P, Domagała M, Domański H, Doszel A, Duda D, Dudkowska M, Dudziuk B, Dybciak P, Dymanowski M, Dziadzio-Bolek L, Eicke M, El-Hassan H, Eremus A, Fąferek-Muller M, Figura-Roguska E, Fijałkowska-Kaczmarek I, Flis M, Florczak T, Florczuk M, Foryszewska-Witan E, Frydrych W, Fugiel A, Futyma E, Gaca-Jaroszewicz A, Gajdamowicz I, Ganczarski K, Gatnar A, Gers M, Głowacki A, Głód K, Godula J, Gołąb J, Gołębiewski M, Goszczyńska E, Gościcka K, Górna-Hajduga A, Górny E, Grabowska T, Grabowski R, Graczyk-Duda A, Gromow A, Grudewicz A, Gruszecka J, Gruszka A, Gryboś J, Grzebyk J, Grzechowiak A, Grzesiak D, Grześkowiak T, Guźla A, Hachuła G, Hawel B, Hiltawska H, Honkowicz E, Ignatowicz J, Imielski K, Iwaniura A, Jagieła-Szymala A, Jalć-Sowała M, Janczylik A, Janisz E, Janiszek M, Jankiewicz-Ziobro K, Januszewska K, Jaremek A, Jaros-Urbaniak A, Jarosz J, Jarosz P, Jasiński W, Jezierska-Wasilewska M, Jędraszewski T, Jędrzejowska A, Józefowicz R, Jóźwiak J, Juźwin K, Kacprzak E, Kaczmarek-Szewczyk J, Kaczmarzyk M, Kandziora R, Kaniewski C, Karolak-Brandt L, Kasperczyk S, Kasperek-Dyląg E, Kedziora I, Kępa A, Kiciński J, Kielak-Al-Hosam J, Kiełczawa Ł, Kilimowicz P, Kitliński K, Kiwka T, Klein U, Klichowicz L, Klimowicz A, Klonowski B, Kmolek B, Kobyłko-Klepacka E, Kocoń A, Kolenda A, Kollek E, Kopeć M, Koper-Kozikowska B, Koralewska J, Korczyńska M, Korzeniewski M, Kosk A, Kotarski K, Kowalczyk E, Kowalczyk M, Kowalik I, Kozak-Błażkiewicz B, Kozik M, Kozłowska D, Kozłowska E, Kozłowska M, Kozubski T, Kózka K, Kraśnik L, Krężel T, Krochmal B, Król B, Król G, Król J, Królikowska T, Kruszewska H, Krygier-Potrykus B, Krystek W, Krzysztoń J, Kubicki T, Kuczmierczyk-El-Hassan A, Kuczyńska-Witek W, Kujda D, Kurowski A, Kurzelewska-Solarz I, Kwaczyńska M, Kwaśniak M, Kwaśniak P, Kwietniewska T, Łebek-Ordon A, Lebiedowicz A, Lejkowska-Olszewska L, Lentas M, Lesiewicz-Ksycińska A, Limanowski M, Łoniewski S, Łopata J, Łubianka B, Łukasiuk I, Łużna M, Łysiak M, Łysik B, Machowski Z, Maciaczyk-Kubiak J, Mackiewicz-Zabochnicka G, Magner-Krężel Z, Majda S, Malinowski P, Mantyka J, Marchlik E, Martyna-Ordyniec G, Marzec J, Marzec M, Matejko-Wałkiewicz R, Mazur M, Michalczak M, Michalska-Żyłka A, Michniewicz M, Mika-Staniszewska D, Mikiciuk E, Mikołajczak T, Milewski J, Miller E, Misiaszek B, Mizik-Łukowska M, Młyńczyk-Pokutycka E, Mocek M, Moczała M, Morawska-Hermanowicz M, Moryc P, Moskal A, Moskal S, Moździerz A, Moździerz P, Mrozińska M, Mrozowicz K, Mróz G, Munia T, Mura A, Muras-Skudlarska M, Murawska E, Murawski Ł, Murawski R, Musielak R, Nadaj K, Nagarnowicz W, Napierała R, Niedźwiecka M, Niemirski A, Nikiel J, Nosal M, Nowacki W, Nowak J, Nyrka M, Obst A, Ochowicz J, Ogonowska E, Oleszczyk M, Ołdakowski A, Ołowniuk-Stefaniak I, Ordowska-Rejman J, Orliński M, Osińska B, Ostańska-Burian A, Paciorkowska A, Paczkowska U, Paluch L, Pałka L, Paszko-Wojtkowska J, Paszkowska A, Pawlak-Ganczarska E, Pawlik W, Pawłowska I, Paździora M, Permiakow G, Petlic-Marendziak A, Piasecka T, Piaścińska E, Piktel A, Pilarska-Igielska A, Piotrkowska A, Piwowar-Klag K, Planer M, Plewa J, Płatkiewicz P, Płonczyńska B, Podgórska A, Polewska M, Porębska B, Porwoł P, Potakowska I, Prokop A, Przybylski J, Przybyła M, Psiuk H, Ptak K, Puzoń G, Rabiza N, Rachwalik S, Raczyńska E, Raniszewska M, Romanek-Kozik A, Rosa A, Rosa K, Rozewicz A, Rudzka-Kałwak J, Rusak J, Rutkowska D, Rybacki M, Rybińska D, Rycyk-Sadowska A, Rynda L, Rynkiewicz B, Sadowska-Krawczyk B, Sadowska-Zarzycka M, Sarnecka B, Sawalach-Tomanik E, Sidor-Drozd B, Siemieniak-Dębska M, Sieroń A, Siewniak-Zalewska B, Sikora A, Sitarska-Pawlina B, Skorupski J, Skrzypińska-Mansfeld I, Skubisz J, Skwarek R, Słodyczka M, Smentek M, Smolińska K, Solarz B, Sosnowska W, Sroka B, Stachura H, Stangreciak D, Staniak M, Stańczyk Z, Stańszczak-Ozga D, Startek E, Stefańczyk M, Stelmach R, Sternadel-Rączka E, Sternik M, Stępień J, Stocka J, Stokowska-Wojda M, Studler-Karpińska M, Suchorukow W, Sufryd W, Supłacz B, Sygacz J, Szczepański Ł, Szkandera J, Szłapa-Zellner J, Szydlarska D, Śliwa T, Śliwka J, Śmiejkowski Ł, Targońska A, Tesarska E, Tobiasz M, Tomaka J, Tomalska-Bywalec K, Tomiak E, Topczewski S, Trawińska A, Trela-Mucha L, Trojanowski D, Trzaskowska M, Trzcińska-Larska B, Trznadel-Mozul A, Ulanicka-Liwoch K, Urbanowicz M, Uthke-Kluzek A, Waczyński J, Walczak J, Warsz L, Wasyńczuk M, Wąchała-Jędras U, Wąsowicz D, Wczysła J, Wenda F, Werner-Kubicka E, Weryszko E, Węgrzynowska B, Wiaksa M, Wiankowski M, Wicherek A, Wieczorek R, Wiencek R, Wienzek-Tatara G, Wierzbicka B, Wierzbicki M, Wilczyńska B, Wilmańska D, Winiarski P, Wiszniewska-Pabiszczak A, Witkowska M, Witzling J, Wlaź A, Wojtkowiak I, Woydyłło J, Woźniak K, Wójtowicz A, Wrona J, Wrońska M, Wujkowska H, Wyrąbek J, Wysokiński O, Zakrzewski R, Zaleska-Zatkalik J, Zaleski J, Zalewska- Dybciak M, Zalewska E, Zalewska-Uchimiak B, Zawadzka-Krajewska J, Zawadzki J, Zieliński A, Zubrycka E, Żybort I, Żymełka M. Lipid levels, atrial fibrillation and the impact of age: Results from the LIPIDOGRAM2015 study. Atherosclerosis 2020; 312:16-22. [DOI: 10.1016/j.atherosclerosis.2020.08.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/04/2020] [Accepted: 08/13/2020] [Indexed: 12/22/2022]
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Turusheva A, Vaes B, Degryse JM, Frolova E. Low cholesterol levels are associated with a high mortality risk in older adults without statins therapy: An externally validated cohort study. Arch Gerontol Geriatr 2020; 90:104180. [DOI: 10.1016/j.archger.2020.104180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/03/2020] [Accepted: 07/07/2020] [Indexed: 01/23/2023]
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Okin PM, Hille DA, Wachtell K, Kjeldsen SE, Julius S, Devereux RB. On-treatment HDL cholesterol predicts incident atrial fibrillation in hypertensive patients with left ventricular hypertrophy. Blood Press 2020; 29:319-326. [PMID: 32586143 DOI: 10.1080/08037051.2020.1782171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: Hypertensive patients are at increased risk of atrial fibrillation (AF). Although low baseline high density lipoprotein (HDL) cholesterol has been associated with a higher risk of AF, this has not been verified in recent population-based studies. Whether changing levels of HDL over time are more strongly related to the risk of new AF in hypertensive patients has not been examined.Material and methods: Incident AF was examined in relation to baseline and on-treatment HDL levels in 8267 hypertensive patients with no history of AF, in sinus rhythm on their baseline electrocardiogram, randomly assigned to losartan- or atenolol-based treatment. HDL levels at baseline and each year of testing were categorised into quartiles according to baseline HDL levels.Results: During 4.7 ± 1.10 years of follow-up, 645 patients (7.8%) developed new AF. In univariate Cox analyses, compared with the highest quartile of HDL levels (>1.78 mmol/l), patients with on-treatment HDL in the lowest quartile (≤ 1.21 mmol/l) had a 53% greater risk of new AF. Patients with on-treatment HDL in the second and third quartiles had intermediate increased risks of AF. Baseline HDL in the lowest quartile was not a significant predictor of new AF (hazard ratio (HR): 1.14, 95% confidence interval (CI): 0.90-1.43). In multivariable Cox analyses adjusting for multiple baseline and time-varying covariates, the lowest quartile of on-treatment HDL remained associated with a nearly 54% increased risk of new AF (HR: 1.54, 95% CI: 1.16-2.05) whereas a baseline HDL≤ ⩽1.21 mmol/l was not predictive of new AF (HR: 1.01, 95% CI: 0.78-1.31).Conclusion: Lower on-treatment HDL is strongly associated with risk of new AF. These findings suggest that serial assessment of HDL can estimate AF risk better than baseline HDL in hypertensive patients with left ventricular hypertrophy. Future studies may investigate whether therapies that increase HDL can lower risk of developing AF.Clinical Trials Registration: http://clinicaltrials.gov/ct/show/NCT00338260?order=1.
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Affiliation(s)
- Peter M Okin
- Division of Cardiology, Weill Cornell Medical College, New York, NY, USA
| | | | | | - Sverre E Kjeldsen
- Department of Cardiology, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Cardiovascular Medicine, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - Stevo Julius
- Division of Cardiovascular Medicine, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - Richard B Devereux
- Division of Cardiology, Weill Cornell Medical College, New York, NY, USA
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Shang L, Shao M, Guo Q, Xiaokereti J, Zhao Y, Lu Y, Zhang L, Tang B, Zhou X. Association of Obesity Measures with Atrial Fibrillation Recurrence After Cryoablation in Patients with Paroxysmal Atrial Fibrillation. Med Sci Monit 2020; 26:e920429. [PMID: 32102988 PMCID: PMC7061586 DOI: 10.12659/msm.920429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 02/10/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Obesity increases the risk of atrial fibrillation (AF) recurrence after ablation. This study explored the relationship between various obesity indexes and risk of recurrence after cryoablation of paroxysmal AF (PAF). MATERIAL AND METHODS Our prospective study included 100 patients with PAF who underwent first cryoablation. Physical examination and fasting blood lipids levels were measured at baseline. Seven obesity indexes were determined: body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-hip ratio (WHR), cardiometabolic index (CMI), lipid accumulation product (LAP), and body adiposity index (BAI). AF recurrence was confirmed by electrocardiograms and Holter monitor at follow-up visits after the initial 3-month blanking period. Receiver operating characteristic (ROC) curves were drawn to assess the abilities of obesity indicators in predicting AF recurrence. Multivariable Cox regression analysis was used to examine independent predictors of AF recurrence. RESULTS During a mean follow-up of 13.4 months, 31 patients (31.0%) had recurrent AF. Patients with recurrence had higher BMI, WC, WHtR, LAP, and BAI compared with those without recurrence. ROC analysis indicated the potential predictive value of BAI with an AUC of 0.657 (95% confidence interval [CI]: 0.534-0.779), followed by WC, WHtR, LAP, and BMI (all P<0.05). Diagnosis-to-ablation time (HR 1.034, 95% CI: 1.002-1.068), left atrial diameter (HR 1.147, 95% CI: 1.026-1.281), and WC (HR 1.026, 95% CI: 1.000-1.053) were independent predictive factors for AF recurrence after multivariable adjustment. CONCLUSIONS In this study population, WC appears to be a potential indicator for the prediction of recurrence in patients with PAF after cryoablation.
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Affiliation(s)
- Luxiang Shang
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
| | - Mengjiao Shao
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
| | - Qilong Guo
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
| | - Jiasuoer Xiaokereti
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
| | - Yang Zhao
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
| | - Yanmei Lu
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
| | - Ling Zhang
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
- Clinical Medical Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
| | - Baopeng Tang
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
| | - Xianhui Zhou
- Department of Pacing and Electrophysiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China
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The Pathogenic Role of Very Low Density Lipoprotein on Atrial Remodeling in the Metabolic Syndrome. Int J Mol Sci 2020; 21:ijms21030891. [PMID: 32019138 PMCID: PMC7037013 DOI: 10.3390/ijms21030891] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/24/2020] [Accepted: 01/28/2020] [Indexed: 12/16/2022] Open
Abstract
Atrial fibrillation (AF) is the most common persistent arrhythmia, and can lead to systemic thromboembolism and heart failure. Aging and metabolic syndrome (MetS) are major risks for AF. One of the most important manifestations of MetS is dyslipidemia, but its correlation with AF is ambiguous in clinical observational studies. Although there is a paradoxical relationship between fasting cholesterol and AF incidence, the benefit from lipid lowering therapy in reduction of AF is significant. Here, we reviewed the health burden from AF and MetS, the association between two disease entities, and the metabolism of triglyceride, which is elevated in MetS. We also reviewed scientific evidence for the mechanistic links between very low density lipoproteins (VLDL), which primarily carry circulatory triglyceride, to atrial cardiomyopathy and development of AF. The effects of VLDL to atria suggesting pathogenic to atrial cardiomyopathy and AF include excess lipid accumulation, direct cytotoxicity, abbreviated action potentials, disturbed calcium regulation, delayed conduction velocities, modulated gap junctions, and sarcomere protein derangements. The electrical remodeling and structural changes in concert promote development of atrial cardiomyopathy in MetS and ultimately lead to vulnerability to AF. As VLDL plays a major role in lipid metabolism after meals (rather than fasting state), further human studies that focus on the effects/correlation of postprandial lipids to atrial remodeling are required to determine whether VLDL-targeted therapy can reduce MetS-related AF. On the basis of our scientific evidence, we propose a pivotal role of VLDL in MetS-related atrial cardiomyopathy and vulnerability to AF.
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Arrhythmia paradox in patients with familial hypercholesterolemia. J Clin Lipidol 2020; 14:154. [PMID: 31964619 DOI: 10.1016/j.jacl.2019.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 12/18/2019] [Indexed: 11/23/2022]
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Lee H, Lee S, Choi E, Han K, Oh S. Low Lipid Levels and High Variability are Associated With the Risk of New-Onset Atrial Fibrillation. J Am Heart Assoc 2019; 8:e012771. [PMID: 31771440 PMCID: PMC6912974 DOI: 10.1161/jaha.119.012771] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background While high levels of lipids and lipid variability are established risk factors for atherosclerotic cardiovascular disease, their roles in the development of atrial fibrillation (AF) are unclear, with previous studies suggesting a “cholesterol paradox.” Methods and Results A nationwide population‐based cohort of 3 660 385 adults (mean age 43.4 years) from the Korean National Health Insurance Service database, with ≥3 annual lipid measurements from 2009 to 2012 and without a history of AF or prescription of lipid‐lowering medication before 2012, were identified. Total cholesterol, low‐density lipoprotein cholesterol, high‐density lipoprotein cholesterol, and triglycerides levels were measured, and lipid variability was calculated using variability independent of the mean. The cohort was divided into quartiles by lipid levels and lipid variability and followed up for incident AF. During a median 5.4 years of follow‐up, AF was newly diagnosed in 27 581 (0.75%). AF development was inversely associated with high lipid levels (for top versus bottom quartile; total cholesterol, HR 0.78, 95% CI 0.76–0.81; low‐density lipoprotein cholesterol, HR 0.81, 95% CI 0.78–0.84; high‐density lipoprotein cholesterol, HR 0.94, 95% CI 0.91–0.98; triglycerides, HR 0.88, 95% CI 0.85–0.92). Meanwhile, AF development was associated with high lipid variability (for top versus bottom quartile; total cholesterol, HR 1.09, 95% CI 1.06–1.13; low‐density lipoprotein cholesterol, HR 1.12, 95% CI 1.08–1.16; high‐density lipoprotein cholesterol, HR 1.08, 95% CI 1.04–1.12; triglycerides, HR 1.05, 95% CI 1.01–1.08). Men showed greater risk reduction with high triglyceride levels and greater risk with high triglyceride variability for incident AF. Conclusions Low cholesterol levels and high cholesterol variability were associated with a higher risk of AF development.
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Affiliation(s)
- Hyun‐Jung Lee
- Department of Internal MedicineSeoul National University HospitalSeoulRepublic of Korea
| | - So‐Ryoung Lee
- Department of Internal MedicineSeoul National University HospitalSeoulRepublic of Korea
| | - Eue‐Keun Choi
- Department of Internal MedicineSeoul National University HospitalSeoulRepublic of Korea
| | - Kyung‐Do Han
- Department of Medical StatisticsCollege of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
| | - Seil Oh
- Department of Internal MedicineSeoul National University HospitalSeoulRepublic of Korea
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Wieland M, Mann S, Gollnick NS, Majzoub-Altweck M, Knubben-Schweizer G, Langenmayer MC. Alopecia in Belgian Blue crossbred calves: a case series. BMC Vet Res 2019; 15:411. [PMID: 31730460 PMCID: PMC6858713 DOI: 10.1186/s12917-019-2140-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 10/14/2019] [Indexed: 11/16/2022] Open
Abstract
Background Alopecia is defined as the partial or complete absence of hair from areas of the body where it normally grows. Alopecia secondary to an infectious disease or parasitic infestation is commonly seen in cattle. It can also have metabolic causes, for example in newborn calves after a disease event such as diarrhoea. In the article, the investigation of a herd problem of acquired alopecia in Belgian Blue (BB) crossbred calves is described. Case presentation Several BB crossbred calves had presented with moderate to severe non-pruritic alopecia in a single small herd located in Southern Germany. The referring veterinarian had ruled out infectious causes, including parasitic infection and had supplemented calves with vitamins (vitamins A, B1, B2, B3, B5, B6, B7, B9, B12, C, and K3) orally. Results of the diagnostic workup at the Clinic for Ruminants are presented for three affected calves and findings from a farm visit are discussed. Because of these investigations, an additional four calves were brought to the referral clinic within the first week of life, and before onset of alopecia, in order to study the course of the condition; however, these calves never developed any signs of alopecia during their clinic stay. Conclusions Because all other plausible differential diagnoses were ruled out during our investigation, we concluded that the documented alopecia was due to malabsorption of dietary fat and consecutive disruption of lipid metabolism leading to telogen or anagen effluvium. In this particular case, this was caused by a mixing error of milk replacer in conjunction with insufficiently tempered water. We conclude that nutritional, management or environmental factors alone can lead to moderate to severe alopecia in calves in the absence of a prior or concurrent disease event or infectious cause.
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Affiliation(s)
- Matthias Wieland
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre for Clinical Veterinary Medicine, Veterinary Faculty, Ludwig-Maximilians-Universität München, Sonnenstrasse 16, 85764, Oberschleissheim, Germany. .,Present Address: Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, 14853, USA.
| | - Sabine Mann
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre for Clinical Veterinary Medicine, Veterinary Faculty, Ludwig-Maximilians-Universität München, Sonnenstrasse 16, 85764, Oberschleissheim, Germany.,Present Address: Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, 14853, USA
| | - Nicole S Gollnick
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre for Clinical Veterinary Medicine, Veterinary Faculty, Ludwig-Maximilians-Universität München, Sonnenstrasse 16, 85764, Oberschleissheim, Germany.,Present Address: German Federal Institute for Risk Assessment, Max-Dohrn-Str. 8-10, 10589, Berlin, Germany
| | - Monir Majzoub-Altweck
- Institute of Veterinary Pathology at the Centre for Clinical Veterinary Medicine, Veterinary Faculty, Ludwig-Maximilians-Universität München, Veterinärstr. 13, 80539, Munich, Germany
| | - Gabriela Knubben-Schweizer
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre for Clinical Veterinary Medicine, Veterinary Faculty, Ludwig-Maximilians-Universität München, Sonnenstrasse 16, 85764, Oberschleissheim, Germany
| | - Martin C Langenmayer
- Institute of Veterinary Pathology at the Centre for Clinical Veterinary Medicine, Veterinary Faculty, Ludwig-Maximilians-Universität München, Veterinärstr. 13, 80539, Munich, Germany.,Present Address: Institute for Infectious Diseases and Zoonoses, Ludwig-Maximilians-Universität München, Veterinärstr. 13, 80539, Munich, Germany
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Association Between HDL Cholesterol and QTc Interval: A Population-Based Epidemiological Study. J Clin Med 2019; 8:jcm8101527. [PMID: 31547597 PMCID: PMC6832837 DOI: 10.3390/jcm8101527] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/16/2019] [Accepted: 09/18/2019] [Indexed: 01/06/2023] Open
Abstract
Previous experimental studies showed that increasing high-density lipoprotein cholesterol (HDL) cholesterol shortens cardiac ventricular repolarization and the QT interval corrected for heart rate (QTc). However, little is known about the epidemiological relationship between HDL and QTc. The potential antiarrhythmic effect of HDL cholesterol remains a speculative hypothesis. In this cross-sectional population based study in adults living in the Italian-speaking part of Switzerland, we aimed to explore the association between HDL cholesterol and the QTc interval in the general population. A total of 1202 subjects were screened. electrocardiogram (ECG) recordings, measurements of lipid parameters and other laboratory tests were performed. QTc was corrected using Bazett’s (QTcBaz) and Framingham (QTcFram) formulas. HDL was categorized according to percentile distributions: <25th (HDL-1; ≤1.39 mmol/L); 25th–<50th (HDL-2; 1.40–1.69 mmol/L); 50th–<75th (HDL-3; 1.69–1.99 mmol/L); and ≥75th (HDL-4; ≥2.0 mmol/L). After exclusion procedures, data of 1085 subjects were analyzed. Compared with the HDL reference group (HDL-1), HDL-2 and HDL-3 were associated with a reduction of QTcBaz and QTcFram duration in crude (HDL-2, QTcBaz/QTcFram: β-11.306/–10.186, SE 4.625/4.016; p = 0.016/0.012; HDL-3, β-12.347/–12.048, SE 4.875/4.233, p = 0.012/<0.001) and adjusted (HDL-2: β-11.697/–10.908, SE 4.333/4.151, p < 0.001/0.010; HDL-3 β-11.786/–11.002, SE 4.719/4.521, p = 0.014/0.016) linear regression models in women. In adjusted logistic regression models higher HDL, were also associated with lower risk of prolonged QTcBaz/QTcFram (HDL-2: OR 0.16/0.17, CI 0.03–0.83/0.47–0.65; HDL-3: OR 0.10/0.14, CI 0.10–0.64/0.03–0.63) in women. Restricted cubic spline analysis confirmed a non linear association (p < 0.001). The present findings indicate an epidemiological association between HDL cholesterol and QTc duration. To draw firm conclusions, further investigations in other populations and with a prospective cohort design are needed.
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Yaroslavskaya EI, Kuznetsov VA, Gorbatenko EA, Marinskikh LV. [Association of Atrial Fibrillation with Coronary Lesion in Ischemic Heart Disease Patients]. ACTA ACUST UNITED AC 2019; 59:5-12. [PMID: 31540571 DOI: 10.18087/cardio.2019.9.2641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 09/20/2019] [Indexed: 11/18/2022]
Abstract
AIM to find out whether atrial fibrillation (AF) in patients with ischemic heart disease (IHD) is related to some definite localization or extent of coronary artery lesions or type of coronary circulation. MATERIALS AND METHODS We compared data of clinical, laboratory, and instrumental examination of 178 IHD patients from the Registry of coronary angiography of patients with AF (main group) and 331 patients (comparison group) selected according to propensity score matching with balancing by sex, age, body mass index, severity of chronic heart failure, frequency of myocardial infarctions, detection of arterial hypertension, and thyroid diseases. RESULTS The groups did not differ in terms of alcohol use, frequency of smoking, and detection of diabetes. Patients with AF compared with those without had higher mean heart rate (105±32 vs. 70±13 bpm, р<0.001), lower level of triglycerides (1.74±1.08 vs. 1.94±1.17 mmol / l, р=0.019). AF patients more rarely had class III-IV effort angina (52.9 % vs. 66.5 %, р=0.041). Rate of detection of left ventricular (LV) dilatation and index of LV asynergy in both groups were similar, but absolute dimensions and indexes of LV, left atrium, right ventricle, LV myocardial mass were higher in the AF group. Hemodynamically significant mitral regurgitation and lowering of LV contractility were more often detected in patients with AF (49.1 % vs. 18.4 %, р<0.001, and 56.2 % vs. 39.5 %, р<0.001, in main and comparison groups, respectively). Analysis of coronary angiography data showed that patients with compared with those without AF more often had right type of coronary circulation (87.5 % vs. 80.4 %, р=0.043) as well as lesions of the right coronary artery (92.1 % vs. 85.8 %, р=0.037), and less often lesions of left coronary artery trunk (16.3 % vs. 24.8 %, р=0.027). CONCLUSION AF in patients with IHD is associated with right coronary artery lesions and right type of coronary circulation.
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Affiliation(s)
- E I Yaroslavskaya
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences
| | - V A Kuznetsov
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences
| | - E A Gorbatenko
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences
| | - L V Marinskikh
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences
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Roh E, Chung HS, Lee JS, Kim JA, Lee YB, Hong SH, Kim NH, Yoo HJ, Seo JA, Kim SG, Kim NH, Baik SH, Choi KM. Total cholesterol variability and risk of atrial fibrillation: A nationwide population-based cohort study. PLoS One 2019; 14:e0215687. [PMID: 31017966 PMCID: PMC6481829 DOI: 10.1371/journal.pone.0215687] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 04/05/2019] [Indexed: 12/24/2022] Open
Abstract
Background Long-term variability of cardiometabolic risk factors have been suggested as the risk factors for cardiovascular disease and mortality. However, the effect of long-term variability of total cholesterol (TC) on incident atrial fibrillation (AF) has not been examined. Methods and findings We explored whether visit-to-visit TC variability are associated with the risk of incident AF in 160,165 Korean adults, using the population-based Korean National Health Insurance Service–Health Screening Cohort (NHIS-HEALS) database, over a median duration of 8.4 years. TC variability was measured as coefficients of variance (TC-CV), standard deviation (TC-SD), and variability independent of the mean (TC-VIM). Kaplan–Meier analysis demonstrated a decreased disease-free probability in the highest quartile group of TC variability compared to that in the other groups. In the multivariate Cox proportional hazard analysis, the risk of AF increased significantly in the highest quartile group of TC variability. After multivariate adjustment for confounding variables including mean TC levels, the hazard ratio for incident AF was 1.15 (95% confidence interval 1.05–1.25; P = 0.0035) when comparing the highest with the lowest TC variability quartile (TC-CV). These relationships were consistent with TC variability defined using TC-SD or TC-VIM. Subgroup analyses, including age, sex, body mass index, and cardiometabolic disorders, showed similar results. Conclusions The present study is the first to demonstrate that high TC variability was associated with an increased risk of AF.
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Affiliation(s)
- Eun Roh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hye Soo Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Ji Sung Lee
- Clinical Research Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung A. Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - So-hyeon Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji A. Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- * E-mail:
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Shang Y, Chen N, Wang Q, Zhuo C, Zhao J, Lv N, Huang Y. Blood lipid levels and recurrence of atrial fibrillation after radiofrequency catheter ablation: a prospective study. J Interv Card Electrophysiol 2019; 57:221-231. [DOI: 10.1007/s10840-019-00543-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 03/21/2019] [Indexed: 11/30/2022]
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Ulus T, Isgandarov K, Yilmaz AS, Vasi I, Moghanchızadeh SH, Mutlu F. Predictors of new-onset atrial fibrillation in elderly patients with acute coronary syndrome undergoing percutaneous coronary intervention. Aging Clin Exp Res 2018; 30:1475-1482. [PMID: 29500621 DOI: 10.1007/s40520-018-0926-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 02/26/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND The development of atrial fibrillation (AF) during the course of acute coronary syndrome (ACS) is related to poor prognosis. Possible predictors of new-onset AF (NOAF) have not been adequately investigated in elderly patients with ACS undergoing percutaneous coronary intervention (PCI). We aimed to identify the factors associated with NOAF in such patients. METHODS A total of 308 elderly patients with ACS undergoing PCI were enrolled in the study. Patients were divided into two groups: without NOAF [254 patients, 64.6% men, age: 73.5 (69.0-79.0) years] and with NOAF [54 patients, 70.4% men, age: 75.0 (68.7-81.2) years]. Clinical, angiographic, and laboratory features including neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-high-density lipoprotein ratio (MHR) were compared between the groups. RESULTS The percentages of prior myocardial infarction (MI) (20.4 vs. 5.9%) and Killip III/ IV (24.1 vs. 7.1%), NLR [4.5 (2.6-7.2) vs. 3.2 (2.0-6.0)], and MHR [19.4 (15.7-26.5) vs. 12.9 (9.9-18.5)] were higher in patients with NOAF compared to the others (p = 0.020, < 0.001, 0.030, and < 0.001, respectively). In multivariate regression analysis, prior MI (OR 4.509, 95% CI 1.679-12.106, p = 0.003) and MHR (OR 1.102, 95% CI 1.054-1.152, p < 0.001) independently predicted NOAF. In addition, Killip III/IV was found to be an independent predictor of 6-month overall mortality (HR 2.949, 95% CI 1.218-7.136, p = 0.016). CONCLUSIONS Prior MI and MHR are independent predictors of NOAF in elderly patients with ACS undergoing PCI. Killip III/IV predicts 6-month overall mortality in such patients.
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Role of the monocyte-to-high-density lipoprotein ratio in predicting atrial high-rate episodes detected by cardiac implantable electronic devices. North Clin Istanb 2018; 5:96-101. [PMID: 30374473 PMCID: PMC6191558 DOI: 10.14744/nci.2017.35761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 09/06/2017] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE: Technological advances have allowed cardiac implantable electronic devices (CIEDs) to detect, analyze, and store atrial high-rate episodes (AHREs), which are surrogate for the term silent atrial fibrillation (AF). The association of AHREs with adverse clinical events has been demonstrated in several recent studies, implying that morbidity and mortality can be significantly prevented by prompt recognition and intervention. Inflammation and oxidative stress are among several mechanisms that contribute to the pathogenesis of AF. The monocyte-to-high-density lipoprotein ratio (M/H ratio) is a novel indicator of both inflammation and oxidative stress. In this study, we aimed to investigate the value of the M/H ratio for predicting AHREs detected by CIEDs. METHODS: A total of 203 patients (mean age: 57.5+9.1 years, 60.1% male) implanted with a dual pacemaker because of sick sinus syndrome were included. Blood samples were obtained from the patients after 12 h of fasting for the analysis of routine biochemistry tests and the lipid panel in the morning of device implantation. At a clinical visit 6 months after CIED implantation, the devices were interrogated to detect the occurrence of AHREs. AHREs were defined as atrial episodes faster than 220 bpm and lasting longer than 5 min. The patients were divided into two groups depending on the presence of AHREs during pacemaker interrogation: Group 1 (AHRE present) and Group 2 (AHRE absent). RESULTS: At the clinical visit 6 months after CIED implantation, 51 (25.1%) patients had at least one AHRE. The M/H ratio was significantly higher in patients in Group 1 (11.41±1.24) than in those in Group 2 (8.17±1.02) (p<0.01). On performing multivariate Cox regression analysis, the M/H ratio was found to be associated with the occurrence of AHREs in patients with CIEDs (OR: 22.813, 95% CI: 6.852–75.953, p<0.01). CONCLUSION: The M/H ratio is an indicator of inflammation and oxidative stress, both of which play an important role in the pathogenesis of AF. This ratio was found to be statically higher in patients with AHREs detected by CIEDs than in those without AHREs.
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Li ZZ, Du X, Guo XY, Tang RB, Jiang C, Liu N, Chang SS, Yu RH, Long DY, Bai R, Sang CH, Li SN, Dong JZ, Ma CS. Association Between Blood Lipid Profiles and Atrial Fibrillation: A Case-Control Study. Med Sci Monit 2018; 24:3903-3908. [PMID: 29885277 PMCID: PMC6024732 DOI: 10.12659/msm.907580] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Dyslipidemia is the most frequent comorbidity in patients with cardiovascular disease. However, studies examining the relationship between blood lipid profiles and AF have produced inconsistent results. Material/Methods A total of 651 patients were enrolled into 3 groups: Healthy controls (n=64), Paroxysmal AF (PAF; n=270), and Continuous AF (CAF; n=317). All enrolled patients underwent routine baseline 12-lead electrocardiography (ECG) and 24-h dynamic ECG along with blood testing, which included the following: complete metabolic panel, hepatic function, renal function, circulating thyroxine, fasting high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and total cholesterol (TC). Results Patients with AF had significantly higher levels of triglycerides (TG), lower levels of LDL-C-c, and lower levels of HDL-C (p<0.05). TC (OR 0.979, p<0.9247) and TG (OR 0.945, p<0.6496) were negatively and linearly associated with PAF, while TG (OR 0.807, p=0.2042), LDL-C (OR 0.334, p=0.0036), and HDL-C (OR 0.136, p=0.0002) were negatively and linearly associated with CAF. Conclusions Compared to healthy controls, patients with AF had lower blood lipid levels, especially LDL-c and HDL-c levels. Hypolipoproteinemia may increase patient susceptibility to developing AF.
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Affiliation(s)
- Zhi-Zhao Li
- Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China (mainland).,Changping District Hospital, Beijing, China (mainland)
| | - Xin Du
- Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China (mainland)
| | - Xue-Yuan Guo
- Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China (mainland)
| | - Ri-Bo Tang
- Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China (mainland)
| | - Chao Jiang
- Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China (mainland)
| | - Nian Liu
- Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China (mainland)
| | - San-Shuai Chang
- Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China (mainland)
| | - Rong-Hui Yu
- Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China (mainland)
| | - De-Yong Long
- Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China (mainland)
| | - Rong Bai
- Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China (mainland)
| | - Cai-Hua Sang
- Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China (mainland)
| | - Song-Nan Li
- Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China (mainland)
| | - Jian-Zeng Dong
- Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China (mainland)
| | - Chang-Sheng Ma
- Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China (mainland)
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Li X, Gao L, Wang Z, Guan B, Guan X, Wang B, Han X, Xiao X, Waleed KB, Chandran C, Wu S, Xia Y. Lipid profile and incidence of atrial fibrillation: A prospective cohort study in China. Clin Cardiol 2018; 41:314-320. [PMID: 29575115 DOI: 10.1002/clc.22864] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 10/26/2017] [Accepted: 11/24/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The association between dyslipidemia, a major risk factor for cardiovascular diseases, and atrial fibrillation (AF) is not clear because of limited evidence. HYPOTHESIS Dyslipidemia may be associated with increased risk of AF in a Chinese population. METHODS A total of 88 785 participants free from AF at baseline (2006-2007) were identified from the Kailuan Study. Fasting levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured at baseline using standard procedures. The study population was stratified based on quartiles of lipid profile. Incident AF was ascertained from electrocardiograms at biennial follow-up visits (2008-2015). The associations between incident AF and the different lipid parameters (TC, LDL-C, HDL-C, and TG) were assessed by Cox proportional hazards regression analysis. RESULTS Over a mean follow-up period of 7.12 years, 328 subjects developed AF. Higher TC (hazard ratio [HR]: 0.60, 95% confidence interval [CI]: 0.43-0.84) and LDL-C (HR: 0.60, 95% CI: 0.43-0.83) levels were inversely associated with incident AF after multivariable adjustment. HDL-C and TG levels showed no association with newly developed AF. The results remained consistent after exclusion of individuals with myocardial infarction or cerebral infarction, or those on lipid-lowering therapy. Both TC/HDL-C and LDL-C/HDL-C ratios were inversely associated with risk of AF (per unit increment, HR: 0.88, 95% CI: 0.79-0.98 and HR: 0.77, 95% CI: 0.66-0.91, respectively). CONCLUSIONS TC and LDL-C levels were inversely associated with incident AF, whereas no significant association of AF with HDL-C or TG levels was observed.
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Affiliation(s)
- Xintao Li
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lianjun Gao
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Zhao Wang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Bo Guan
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xumin Guan
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Binhao Wang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xu Han
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xianjie Xiao
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Khalid Bin Waleed
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Clarance Chandran
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Yunlong Xia
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
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Boudi FB, Kalayeh N, Movahed MR. High-Density Lipoprotein Cholesterol (HDL-C) Levels Independently Correlates With Cardiac Arrhythmias and Atrial Fibrillation. J Intensive Care Med 2018; 35:438-444. [DOI: 10.1177/0885066618756265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Objective: Acute coronary syndrome is frequently complicated by rhythm disturbances, yet any association between high-density lipoprotein (HDL) cholesterol levels and arrhythmias in the setting of non-ST-segment elevation myocardial infarction (non-STEMI) is uncertain. The goal of this study was to evaluate any association between HDL-cholesterol levels and arrhythmias in the setting of non-STEMI. Methods: Retrospective data from Phoenix Veterans Affair Medical Center records were utilized for our study. A total of 6881 patients were found who presented during 2000 to 2003 with non-STEMI with available fasting lipid panels collected within the first 24 hours of admission. Patients were followed for the development of rhythm disturbances up to 6 years after initial presentation, with a mean follow up of 1269 days. Results: We found that high triglycerides/HDL and low-density lipid/HDL ratios were predictive of arrhythmias. However, low HDL levels had strongest association with highest odds ratio (OR) for development of arrhythmias (for HDL <31 mg/dL, OR = 3.72, 95% confidence interval [CI] = 2.55-5.44, P < .05) in patients with diabetes and (for HDL < 31 mg/dL, OR = 3.69, 95% CI = 2.85-4.71, P < .05) in patients without diabetes. Using multivariate analysis adjusting for comorbidities, low HDL level remained independently associated with arrhythmias. Conclusions: Patients with low HDL levels during hospitalization with non-STEMI have a greater risk of developing cardiac rhythm disturbances independent of other risk factors. These data suggest a possible protective role of HDL in preventing arrhythmias in the setting of acute coronary syndrome.
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Affiliation(s)
- Farzin Brian Boudi
- Phoenix Veterans Administration Health Care System, Phoenix, AZ, USA
- University of Arizona College of Medicine, Phoenix, AZ, USA
| | | | - Mohammad Reza Movahed
- CareMore HealthCare, Tucson, AZ, USA
- University of Arizona College of Medicine, Tucson, AZ, USA
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Garg PK, O'Neal WT, Ogunsua A, Thacker EL, Howard G, Soliman EZ, Cushman M. Usefulness of the American Heart Association's Life Simple 7 to Predict the Risk of Atrial Fibrillation (from the REasons for Geographic And Racial Differences in Stroke [REGARDS] Study). Am J Cardiol 2018; 121:199-204. [PMID: 29153246 DOI: 10.1016/j.amjcard.2017.09.033] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 09/21/2017] [Accepted: 09/25/2017] [Indexed: 11/26/2022]
Abstract
The American Heart Association has identified metrics of ideal cardiovascular (CV) health known as Life's Simple 7 (LS7). We determined the prospective relationship between the LS7 and the incident atrial fibrillation (AF) in a biracial cohort. The REasons for Geographic And Racial Differences in Stroke (REGARDS) study enrolled non-Hispanic black and white adults 45 years or older. This analysis included 9,576 REGARDS participants (mean age 63 ± 8.4 years; 57% women; 30% black) who were free of AF at baseline and completed a follow-up examination 9.4 years later. An overall LS7 score was calculated at baseline as the sum of the LS7 component scores and classified as inadequate (0 to 4), average (5 to 9), or optimal (10 to 14) CV health. The primary outcome was incident AF, identified at follow-up by either electrocardiogram or a self-reported medical history of a physician diagnosis. A total of 725 incident AF cases were detected. Compared with the inadequate category (n = 534), participants in the optimal category (n = 1,953) had a 32% lower odds of developing AF (odds ratio 0.68; 95% confidence interval 0.47, 0.99) in a logistic regression model adjusted for demographic characteristics, alcohol use, left ventricular hypertrophy, coronary heart disease, and stroke. A 1-point higher LS7 score was associated with a 5% lower odds of incident AF (odds ratio = 0.95; 95% confidence interval 0.91, 0.99). In conclusion, better CV health, as defined by the LS7 score, is associated with a reduction in development of AF.
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Szczepańska-Szerej A, Kurzepa J, Grabarska A, Bielewicz J, Wlizło-Dyś E, Rejdak K. Correlation between CH 2DS 2-VASc Score and Serum Leptin Levels in Cardioembolic Stroke Patients: The Impact of Metabolic Syndrome. Int J Endocrinol 2017; 2017:7503763. [PMID: 29225622 PMCID: PMC5684549 DOI: 10.1155/2017/7503763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 09/05/2017] [Accepted: 09/26/2017] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To determine adipokines levels in patients with different etiologic subtypes of acute ischemic stroke (AIS) and metabolic syndrome (MetS) status. METHODS Serum adiponectin, leptin, and resistin levels were determined by ELISA in 99 AIS patients and 59 stroke-free control group subjects. Stroke patients were grouped based on MetS, modified TOAST classification, and CHA2DS2-VASc scale in case of cardioembolic stroke following atrial fibrillation. RESULTS No differences were found in all adipokine serum levels between AIS patients and appropriately matched control group. MetS-AIS patients had significantly higher leptin levels (22.71 ± 19.01 ng/ml versus 8.95 ± 9.22 ng/ml, p < 0.001) and lower adiponectin levels (10.71 ± 8.59 ng/ml versus 14.93 ± 10.95 ng/ml, p < 0.05) than non-MetS-AIS patients. In patients with cardioembolic stroke, leptin levels were significantly higher than in remaining stroke cases (19.57 ± 20.53 ng/ml versus 13.17 ± 12.36 ng/ml, p < 0.05) and CHA2DS2-VASc score positively correlated with leptin levels only (p < 0.001). Analysis of individual components of CHA2DS2-VASc score showed that hypertension, female gender, and diabetes had greatest impact on elevated serum leptin level. CONCLUSION This pilot study revealed that leptin could be a potential biomarker for risk stratification of cardioembolic stroke in MetS patients and that heterogeneity of stroke subtypes should be considered for more refined and precise clinical stroke studies.
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Affiliation(s)
| | - Jacek Kurzepa
- Department of Medical Chemistry, Medical University of Lublin, Lublin, Poland
| | - Aneta Grabarska
- Department of Biochemistry and Molecular Biology, Medical University of Lublin, Lublin, Poland
| | - Joanna Bielewicz
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Ewa Wlizło-Dyś
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
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Association of admission serum laboratory parameters with new-onset atrial fibrillation after a primary percutaneous coronary intervention. Coron Artery Dis 2016; 27:128-34. [PMID: 26693808 DOI: 10.1097/mca.0000000000000333] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES New-onset atrial fibrillation (NOAF) during hospitalization is considered a frequent complication associated with worse outcomes in the setting of ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the association of admission serum laboratory parameters, neutrophil to lymphocyte ratio (NLR), and monocyte to high-density lipoprotein ratio (MHR) with NOAF in STEMI patients treated with a primary percutaneous coronary intervention (PCI). PATIENTS AND METHODS A total of 621 patients who were hospitalized with a diagnosis of STEMI and treated with primary PCI were retrospectively enrolled in the study. NOAF during index hospitalization and overall mortality were reported as the clinical outcomes. RESULTS In our study population, 40 (6.4%) patients developed NOAF during index hospitalization. Monocyte counts, mean platelet volume (MPV), red cell distribution width (RDW), NLR, MHR, C-reactive protein (CRP), creatinine, glucose, and uric acid levels were higher in the NOAF+ group compared with the NOAF- group. In multivariate regression analysis, age, left-ventricular ejection fraction, left atrial volumes, admission heart rate, multivessel disease, increased levels of CRP, MPV, RDW, uric acid, NLR, and MHR independently predicted NOAF. In addition, NOAF was found to be an independent predictor of overall mortality in the study population. CONCLUSION For the first time in the literature, admission serum levels of MPV, RDW, uric acid, NLR, and MHR were found to be correlated independently with NOAF after primary PCI.
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40
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Canpolat U, Aytemir K, Yorgun H, Şahiner L, Kaya EB, Çay S, Topaloğlu S, Aras D, Oto A. The role of preprocedural monocyte-to-high-density lipoprotein ratio in prediction of atrial fibrillation recurrence after cryoballoon-based catheter ablation. Europace 2015; 17:1807-1815. [PMID: 25995388 DOI: 10.1093/europace/euu291] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
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41
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Metabolic syndrome, atrial fibrillation, and stroke: Tackling an emerging epidemic. Heart Rhythm 2015; 12:2332-43. [DOI: 10.1016/j.hrthm.2015.06.038] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Indexed: 12/11/2022]
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Mora S, Akinkuolie AO, Sandhu RK, Conen D, Albert CM. Paradoxical association of lipoprotein measures with incident atrial fibrillation. Circ Arrhythm Electrophysiol 2014; 7:612-9. [PMID: 24860180 PMCID: PMC4591535 DOI: 10.1161/circep.113.001378] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 04/22/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Low-density lipoprotein (LDL) cholesterol is a strong risk factor for atherosclerosis but has an inverse association with atrial fibrillation (AF). We aimed to provide insight into the paradoxical association of LDL cholesterol with AF by evaluating the relationship of various lipoprotein measures and incident AF. METHODS AND RESULTS We prospectively evaluated lipoprotein measures among 23 738 healthy middle-aged and older women (median follow-up 16.4 years; N=795 incident AF events). Baseline LDL cholesterol was directly measured, lipoprotein particle concentrations and size were measured by nuclear magnetic resonance spectroscopy, and apolipoproteins were measured by immunoassay. Cox regression models were adjusted for age, AF risk factors, inflammatory, and dysglycemic biomarkers. After multivariable adjustment, inverse associations with AF were observed (hazard ratio, 95% confidence interval for top versus bottom quintile, P value) for LDL cholesterol (0.72, 0.56-0.92, P=0.009), the total number of LDL particles (0.77, 0.60-0.99, P=0.045), and very-low-density lipoprotein particles (0.78, 0.61-0.99, P=0.04), which was driven by the number of cholesterol-poor small LDL (0.78, 0.61-1.00, P=0.05) and small very-low-density lipoprotein particles (0.78, 0.62-0.99, P=0.04). By contrast, the larger cholesterol-rich LDL particles and all high-density lipoprotein measures were not associated with AF in multivariable models. Adjustment for inflammatory and dysglycemic biomarkers had minimal impact on these associations. CONCLUSIONS In this prospective study, the inverse association between LDL cholesterol and AF extended to several other atherogenic lipoproteins, and these associations are unlikely to be mediated by direct cholesterol effects. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov; Unique Identifier: NCT00000479.
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Affiliation(s)
- Samia Mora
- From the Division of Preventive Medicine (S.M., A.O.A., C.M.A.) and Division of Cardiovascular Medicine (S.M., C.M.A.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.K.S.); and Department of Medicine, University Hospital, Basel, Switzerland (D.C.).
| | - Akintunde O Akinkuolie
- From the Division of Preventive Medicine (S.M., A.O.A., C.M.A.) and Division of Cardiovascular Medicine (S.M., C.M.A.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.K.S.); and Department of Medicine, University Hospital, Basel, Switzerland (D.C.)
| | - Roopinder K Sandhu
- From the Division of Preventive Medicine (S.M., A.O.A., C.M.A.) and Division of Cardiovascular Medicine (S.M., C.M.A.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.K.S.); and Department of Medicine, University Hospital, Basel, Switzerland (D.C.)
| | - David Conen
- From the Division of Preventive Medicine (S.M., A.O.A., C.M.A.) and Division of Cardiovascular Medicine (S.M., C.M.A.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.K.S.); and Department of Medicine, University Hospital, Basel, Switzerland (D.C.)
| | - Christine M Albert
- From the Division of Preventive Medicine (S.M., A.O.A., C.M.A.) and Division of Cardiovascular Medicine (S.M., C.M.A.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada (R.K.S.); and Department of Medicine, University Hospital, Basel, Switzerland (D.C.)
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Impact of duration and dosage of statin treatment and epicardial fat thickness on the recurrence of atrial fibrillation after electrical cardioversion. Heart Vessels 2014; 30:490-7. [PMID: 24691701 DOI: 10.1007/s00380-014-0505-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 03/14/2014] [Indexed: 10/25/2022]
Abstract
The purpose of this study was to investigate the time-dependent effect of statin treatment and echocardiographic epicardial fat thickness (EFT) on the maintenance of sinus rhythm (SR) in atrial fibrillation (AF) patients after electrical cardioversion (EC). One hundred sixty-three AF patients without previous statin treatment who underwent EC were consecutively enrolled. The maintenance rate of SR after EC (1, 3, 6, and 12 months) as documented by electrocardiogram and EFT were compared between patients with statin treatment (statin group, n = 63) and those without (no statin group, n = 100). There was no significant difference in the maintenance rate of SR between the groups soon after EC (statin group; 85.7 % vs. no statin; 84.8%, p = 0.535), after 1 month (71.0 vs. 59.1%, p = 0.091), and after 3 months (63.2 vs. 50.0%, p = 0.086). However, the maintenance rate of SR was significantly higher in the statin group compared to no statin group (61.8 vs. 42.9%, p = 0.024) after 6 months, and this significant difference persisted up to 12 months of follow up (60.1 vs. 36.4%, p = 0.001). Patients with recurrence showed higher baseline EFT (7.4 ± 2.7 vs. 8.5 ± 3.0 mm, p = 0.014). Multivariate linear regression analysis indicated that EFT, left atrial diameter, high-density lipoprotein cholesterol, statin treatment, and dose were the significant contributors to the maintenance of SR for all periods after EC. Statin treatment and low EFT were associated with a higher maintenance rate of SR in AF patients after EC. Significant benefit of statin was realized 6 months after EC, and this benefit was shown to be maintained over time.
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Goonasekara CL, Balse E, Hatem S, Steele DF, Fedida D. Cholesterol and cardiac arrhythmias. Expert Rev Cardiovasc Ther 2014; 8:965-79. [DOI: 10.1586/erc.10.79] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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The impact of vagotonic, adrenergic, and random type of paroxysmal atrial fibrillation on left atrial ablation outcomes. Int J Cardiol 2013; 168:4015-8. [DOI: 10.1016/j.ijcard.2013.06.075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Revised: 05/09/2013] [Accepted: 06/30/2013] [Indexed: 11/20/2022]
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Tadic M, Ivanovic B, Cuspidi C. What do we currently know about metabolic syndrome and atrial fibrillation? Clin Cardiol 2013; 36:654-62. [PMID: 23788255 DOI: 10.1002/clc.22163] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 05/17/2013] [Indexed: 12/28/2022] Open
Abstract
Metabolic syndrome represents a cluster of atherogenic risk factors including hypertension, insulin resistance, obesity, and dyslipidemia. Considering that all of these risk factors could influence the development of atrial fibrillation, an association between atrial fibrillation and the metabolic syndrome has been suggested. Additionally, oxidative stress and inflammation have been involved in the pathogenesis of both metabolic syndrome and atrial fibrillation. The mechanisms that relate metabolic syndrome to the increased risk of atrial fibrillation occurrence are not completely understood. Metabolic syndrome and atrial fibrillation are associated with increased cardiovascular morbidity and mortality. Because atrial fibrillation is the most common arrhythmia, and along with the prevalence of metabolic syndrome constantly increasing, it would be very important to determine the relationship between these 2 entities, especially due to the fact that the risk factors of metabolic syndrome are mainly correctable. This review focused on the available evidence supporting the association between metabolic syndrome components and metabolic syndrome as a clinical entity with atrial fibrillation.
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Affiliation(s)
- Marijana Tadic
- Department of Cardiology, University Clinical Hospital Centre "Dr Dragisa Misovic" (Tadic), Belgrade, Serbia; Clinic of Cardiology (Ivanovic), Clinical Centre of Serbia, Belgrade, Serbia; Clinical Research Unit (Cuspidi), University of Milan-Bicocca and Istituto Auxologico Italiano, Meda, Italy
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Bang CN, Gislason GH, Greve AM, Torp-Pedersen C, Køber L, Wachtell K. Statins reduce new-onset atrial fibrillation in a first-time myocardial infarction population: a nationwide propensity score-matched study. Eur J Prev Cardiol 2012; 21:330-8. [DOI: 10.1177/2047487312462804] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Casper N Bang
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark
- Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark
| | - Gunnar H Gislason
- Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark
| | - Anders M Greve
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark
- Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark
| | | | - Lars Køber
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark
| | - Kristian Wachtell
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark
- Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark
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48
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Stratmann B, Tschöpe D. Atrial fibrillation and diabetes mellitus. Correlation, co-existence, and coagulation therapy. Herz 2012; 37:258-63. [PMID: 22453912 DOI: 10.1007/s00059-012-3600-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Epidemiological studies have reported on the association between diabetes mellitus (DM) and subsequent risk of atrial fibrillation (AF) with inconsistent results. Individuals with DM present with an increased risk (approximate 40%) of subsequent AF compared with unaffected individuals, but the mechanisms underlying the relationship between DM and AF remains speculative. Both entities share common risk factors and, thus, seem to be closely associated with each other. Obviously, the quality of glycemic control is directly related with the risk for AF; the risk is higher with longer duration of treated diabetes and poorer glycemic control. Future research should identify approaches to reduce the risk of AF in people with diabetes by means of consequent screening and anti-coagulation therapy.
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Affiliation(s)
- B Stratmann
- Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Deutschland
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Watanabe H, Aizawa Y. Letter by Watanabe and Aizawa Regarding Article, “Blood Lipid Levels, Lipid-Lowering Medications, and the Incidence of Atrial Fibrillation: The Atherosclerosis Risk in Communities (ARIC) Study”. Circ Arrhythm Electrophysiol 2012; 5:e80; author reply e81. [DOI: 10.1161/circep.112.971051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Hiroshi Watanabe
- Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yoshifusa Aizawa
- Department of Cardiology, Tachikawa General Hospital, Nagaoka, Japan
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Association of the metabolic syndrome with atrial fibrillation among United States adults (from the REasons for Geographic and Racial Differences in Stroke [REGARDS] Study). Am J Cardiol 2011; 108:227-32. [PMID: 21530935 DOI: 10.1016/j.amjcard.2011.03.026] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Revised: 03/09/2011] [Accepted: 03/09/2011] [Indexed: 12/21/2022]
Abstract
Metabolic syndrome (MS) and atrial fibrillation (AF) are associated with increased cardiovascular disease morbidity and mortality. This analysis evaluated the association between MS and AF in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. MS was defined using criteria recommended in the joint interim statement from several international societies. AF was defined by electrocardiogram (ECG) and/or self-report and by ECG alone. In patients with 0, 1, 2, 3, 4, and 5 MS components, prevalences of AF by ECG and/or self-report were 5.5%, 7.7%, 8.2%, 9.2%, 9.6%, and 11.5%, respectively (p for trend <0.001). After multivariable adjustment, each MS component except serum triglycerides was significantly associated with AF. The multivariable-adjusted odds ratio for AF, defined by ECG and/or or self-reported history, comparing those with to those without MS was 1.20 (95% confidence interval 1.10 to 1.29). Results were consistent when AF was defined by ECG alone (odds ratio 1.15, 95% confidence interval 0.92 to 1.39). In conclusion, MS is associated with an increased prevalence of AF. Further studies investigating a potential mechanism for this excess risk are warranted.
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