ArticleJournal of lipid and atherosclerosis2023
Evaluation of the Paradoxical Association Between Lipid Levels and Incident Atrial Fibrillation According to Statin Usage: A Nationwide Cohort Study.
Article in Journal of lipid and atherosclerosis, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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
6 citing papers in PubMed, 2 citations in OpenAlex.
- Molecular phenotyping of atrial remodeling in atrial fibrillation usingThe international journal of cardiovascular imaging · 2026Article
- 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
- Association Between HDL Cholesterol Changes and Cardiovascular Event Risk: A Nationwide Health Screening Cohort in Japan.Healthcare (Basel, Switzerland) · 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
- Targeting the Substrate for Atrial Fibrillation: JACC Review Topic of the Week.Journal of the American College of Cardiology · 2024Review
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
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 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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