ArticleJournal of the American Heart Association2019
Low Lipid Levels and High Variability are Associated With the Risk of New-Onset Atrial Fibrillation.
Article in Journal of the American Heart Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- Lipid Variability and Risk of Cardiovascular Diseases and All-Cause Mortality: A Systematic Review and Meta-Analysis of Cohort Studies.Nutrients · 2022Pooled it
- Lipid levels and risk of new-onset atrial fibrillation: A systematic review and dose-response meta-analysis.Clinical cardiology · 2020Pooled it
- Low-density lipoprotein cholesterol is inversely associated with left atrial low-voltage areas in patients with persistent atrial fibrillation: a retrospective cohort study.Lipids in health and disease · 2026Article
- Conventional preoperative parameters associated with new-onset atrial fibrillation after TAVR: a comparative single-center study.Journal of cardiothoracic surgery · 2026Article
- Joint associations of grip strength, lipid levels, and lipid-related genetic risk with atrial fibrillation.Lipids in health and disease · 2026Article
- Circulating lipid profiles and atrial fibrillation: from incident risk to post-ablation recurrence.Frontiers in cardiovascular medicine · 2026Review
- Development of a predictive model for in-hospital new-onset atrial fibrillation in older adults with hypertension and acute myocardial infarction, enhanced by SHAP interpretability: a retrospective cohort study.Frontiers in medicine · 2026Article
- Trajectories of Lipid Profile Changes and Cardiovascular Outcomes in Elderly Asian Patients With Atrial Fibrillation.Journal of arrhythmia · 2025Article
- Metabolic Dysfunction-Associated Steatotic Liver Disease, Alcohol Consumption, and the Risk of Atrial Fibrillation: A Nationwide Population-Based Study.Journal of the American Heart Association · 2025Article
- Improving genetic variant identification for quantitative traits using ensemble learning-based approaches.BMC genomics · 2025Article
- Inverse association between remnant cholesterol and risks of atrial fibrillation among patients with type 2 diabetes.Frontiers in endocrinology · 2025Article
- Machine-learning-based prediction of cardiovascular events for hyperlipidemia population with lipid variability and remnant cholesterol as biomarkers.Health information science and systems · 2024Article
- Construction and validation of a nomogram prediction model for the risk of new-onset atrial fibrillation following percutaneous coronary intervention in acute myocardial infarction patients.BMC cardiovascular disorders · 2024Article
- Atrial Fibrillation Prevalence Rates and Its Association with Cardiovascular-Kidney-Metabolic Factors: SIMETAP-AF Study.Medicina (Kaunas, Lithuania) · 2024Observational
- Association Between Remnant Cholesterol and Risk of Incident Atrial Fibrillation: Population-Based Evidence From a Large-Scale Prospective Cohort Study.Journal of the American Heart Association · 2024Article
- Cholesterol Paradox in Older People with Type 2 Diabetes Mellitus Regardless of Lipid-Lowering Drug Use: A Cross-Sectional Cohort Study.Nutrients · 2023Article
- Lipid Levels and New-Onset Atrial Fibrillation in Patients with Acute Myocardial Infarction.Journal of atherosclerosis and thrombosis · 2023Article
- Association of hyperglycemia ratio and ventricular arrhythmia in critically ill patients admitted to the intensive care unit.BMC cardiovascular disorders · 2023Observational
- Association between cardiovascular risk factors and atrial fibrillation.Frontiers in cardiovascular medicine · 2023Review
- Evaluation of the Paradoxical Association Between Lipid Levels and Incident Atrial Fibrillation According to Statin Usage: A Nationwide Cohort Study.Journal of lipid and atherosclerosis · 2023Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
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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