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

被引:0
作者
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
机构
[1] Huashan Hospital Fudan University,Department of Cardiology
[2] Zhongshan Hospital Fudan University,Department of Cardiology
[3] Tongren Hospital Shanghai Jiaotong University Medical School,Department of Cardiology
[4] Jinshan Hospital Fudan University,Department of Cardiology
[5] Luodian Hospital,Department of Cardiology
[6] Jing’an District Center Hospital,Department of Cardiology
来源
Journal of Thrombosis and Thrombolysis | 2020年 / 50卷
关键词
LDL-C; Thrombosis; Atrial fibrillation; CHA; DS; VASc score;
D O I
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学科分类号
摘要
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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页码:849 / 857
页数:8
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