Clinical Electrophysiology -> Atrial Fibrillation & Atrial Flutter: -> Physiology D-AB26 - Refining Stroke Prevention in Atrial Fibrillation (ID 13) Abstract

D-AB26-02 - Low-density Lipoprotein Cholesterol Predicts Thrombosis In Low-risk Atrial Fibrillation Patients Without Coronary And Peripheral Artery Diseases: More Than Marker For Atherosclerosis? (ID 803)


 W. Liu: Nothing relevant to disclose.

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Background: Low-density lipoprotein cholesterol (LDL-C) was considered to play a critical role in atherosclerosis (AS), however, how it predicts thrombotic events in AF patients without a history of AS remains unknown.
Objective: To investigate the risks of thrombosis ‚Äčin relation to LDL-C among patients with AF but without other known artery vascular disease.
Methods: AF patients without the history of thrombosis at baseline and free of coronary artery disease (CAD) and peripheral artery disease (PAD) enrolled from 5 hospitals were divided into low risk (LR) and high risk (HR) group according to CHA2DS2VASc score (LR: Male less than 2, Female less than 3) and followed up for 4 years for observing thrombotic events.
Results: Thrombosis occurred in 63/953 (6.61%) in LR and 39/495 (7.88%) in HR respectively. The best cut-off value was 2.795mmol/L in LR (AUC 0.613) and 2.515 mmol/L in HR (AUC 0.587). Multivariate analysis showed LDL-C was significantly related to thrombosis in LR (p =0.004), but not in HR group (p=0.16). Different impact of LDL-C between the two groups were also shown in propensity score matching (PSM) after patients were matched in LR (p=0.042) and HR (p=0.51) group. Kaplan-Meier curves displayed patients with high level of LDL-C were at higher thrombosis risk in LR patients.
Conclusion: Among AF patients without prior CAD and PAD, LDL-C is still an independent predictor for thrombosis in low-risk patients. LDL-C acts not only as a marker for AS but also a marker for thrombosis in “low score” AF patients without AS-related diseases. Lipid-lowering therapy could be considered as a supplement to standard anticoagulation for thrombosis reduction in AF population even without AS.