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13.04.2020 | Ausgabe 4/2020

Journal of Thrombosis and Thrombolysis 4/2020

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

Zeitschrift:
Journal of Thrombosis and Thrombolysis > Ausgabe 4/2020
Autoren:
Weizhuo Liu, Nanqing Xiong, Kun Xie, Bangwei Wu, Zhiyong Qi, Peng Zhou, Wen Gao, Liwen Bao, Xiufang Gao, Zhaohui Qiu, Hui Gong, Guibin He, Bin Cao, Haiming Shi, Xinping Luo, Jian Li
Wichtige Hinweise
Weizhuo Liu and Nanqing Xiong have contributed equally to this work.

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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.

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