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A stricter control of low-density lipoprotein is necessary for thrombosis reduction in "lower thrombosis risk" patients with atrial fibrillation: a multicenter retrospective cohort study

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机构: [1]Fudan Univ, Dept Cardiol, Huashan Hosp, 12 Wulumuqizhong Rd, Shanghai 200040, Peoples R China [2]Fudan Univ, Dept Cardiol, Zhongshan Hosp, 180 Fenglin Rd, Shanghai 200032, Peoples R China [3]Shanghai Jiao Tong Univ, Dept Cardiol, Tongren Hosp, Sch Med, 1111 Xianxia Rd, Shanghai 200051, Peoples R China [4]Fudan Univ, Dept Cardiol, Jinshan Hosp, 1508 Longhang Rd, Shanghai 201508, Peoples R China [5]Luodian Hosp, Dept Cardiol, 121 Luoxi Rd, Shanghai 201908, Peoples R China [6]Jingan Dist Ctr Hosp, Dept Cardiol, 259 Xikang Rd, Shanghai 200040, Peoples R China
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关键词: LDL-C Thrombosis Atrial fibrillation CHA(2)DS(2)VASc score

摘要:
Patients with atrial fibrillation (AF) are associated with increased thrombotic events. Our previous case-control study showed low-density lipoprotein cholesterol (LDL-C) was an independent predictor of ischemic stroke in AF patients. To investigate the risks of thrombosis in relation to LDL-C among AF patients at different stroke risks by long-time follow-up. Atrial fibrillation patients without history of thrombosis enrolled from five hospitals were classified into low-risk (LR) and high-risk (HR) group according to CHA(2)DS(2)VASc score and followed up with a median period of 26 months. Univariate and multivariate logistic regression analysis were performed in each group. The best cut-off value calculated by receiver operating characteristic (ROC) analysis was used to divide patients into low LDL-C (L-LDL) and high LDL-C (H-LDL) subgroups. Propensity score matching (PSM) and inverse probability of treatment weighted (IPTW) were utilized in both subgroups, after which Kaplan-Meier curves for thrombosis were performed. Univariate and multivariate analysis showed LDL-C was significantly related to thrombosis in LR, but less significantly in HR group. The best cut-off value was 2.155 mmol/L in LR and 2.795 mmol/L in HR group. Lower LDL-C was associated with decreased thrombosis in both groups by PSM and IPTW. Kaplan-Meier curves displayed that H-LDL subgroup was at higher thrombosis risk with significant difference at 24th month in LR patients. LDL-C independently predicts thrombosis with different cut-off values in AF patients at different risks. A stricter control of LDL-C level is necessary for thrombosis reduction in patients with lower score.

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出版当年[2019]版:
大类 | 3 区 医学
小类 | 4 区 心脏和心血管系统 4 区 血液学 4 区 外周血管病
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 血液学 4 区 心脏和心血管系统 4 区 外周血管病
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出版当年[2018]版:
Q2 PERIPHERAL VASCULAR DISEASE Q2 HEMATOLOGY Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q2 HEMATOLOGY Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Q2 PERIPHERAL VASCULAR DISEASE

影响因子: 最新[2023版] 最新五年平均 出版当年[2018版] 出版当年五年平均 出版前一年[2017版] 出版后一年[2019版]

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第一作者机构: [1]Fudan Univ, Dept Cardiol, Huashan Hosp, 12 Wulumuqizhong Rd, Shanghai 200040, Peoples R China
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