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
- 13 April 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of Thrombosis and Thrombolysis
- Vol. 50 (4), 849-857
- https://doi.org/10.1007/s11239-020-02110-x
Abstract
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 CHA2DS2VASc 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.Keywords
Funding Information
- Natural Science Foundation of Shanghai (17ZR1403700)
- Huashan Hospital Fudan University (2016-716)
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