Low HDL cholesterol is an independent risk factor for new-onset atrial fibrillation in women, highlighting a potential sex-specific link between dyslipidemia and arrhythmogenesis.
BACKGROUND: Dyslipidemia, an important risk factor for cardiovascular disease, may be associated with atrial fibrillation (AF). Cross-sectional studies that have examined this association, however, have produced controversial results, and few longitudinal studies have been conducted. METHODS AND RESULTS: Using annual health examinations in Japan, the association between lipid profile and the risk of new-onset AF was investigated in the general population. A total of 28,449 individuals who did not have AF at baseline were included in the study. During a follow-up of 4.5±2.7 years, 265 individuals (0.9%) developed AF. In multivariate models, low high-density lipoprotein (HDL) cholesterol was associated with the development of AF in women (hazard ratio HR, 2.86; 95% confidence interval CI: 1.49-5.50) but not in men (HR, 1.35; 95%CI: 0.77-2.38). Women had a 28% higher risk of AF with each 10% decrease in HDL cholesterol. Neither triglycerides nor lipid ratios were associated with AF. After excluding individuals with risk factors for AF, including those who were taking anti-hypertensive drugs, had diabetes, and structural heart disease, the association between low HDL cholesterol and AF remained significant in women. CONCLUSIONS: Low HDL cholesterol was associated with an increased risk of new-onset AF in women, but not in men.
Watanabe et al. (Sat,) studied this question.