Lipid levels and risk of new-onset atrial fibrillation: A systematic review and dose-response meta-analysis

Lipid levels are closely associated with health, but whether lipid levels are associated with atrial fibrillation (AF) remains controversial. We thought that blood lipid levels may influence new-onset AF. Here, we used a meta-analysis to examine the overall association between lipid levels and new-onset AF. PubMed and EMBASE databases were searched up to 20 December 2019. We conducted a systematic review and quantitative meta-analysis of prospective studies to clarify the association between lipid levels and the risk of new-onset AF. Sixteen articles with data on 4 032 638 participants and 42 825 cases of AF were included in this meta-analysis. The summary relative risk (RR) for a 1 mmol/L increment in total cholesterol (TC) was 0.95 (95% CI 0.93-0.96, I-2= 74.6%, n = 13). Subgroup analyses showed that follow-up time is a source of heterogeneity; for low-density lipoprotein cholesterol (LDL-C), RR was 0.95 (95% CI 0.92-0.97, I-2= 71.5%, n = 10). Subgroup analyses indicated that adjusting for heart failure explains the source of heterogeneity; for high-density lipoprotein cholesterol (HDL-C), RR was 0.97 (95% CI 0.96-0.99, I-2= 26.1%, n = 11); for triglycerides (TGs), RR was 1.00 (95% CI 0.96-1.03, I-2= 81.1%, n = 8). Subgroup analysis showed that gender, age, follow-up time, and adjustment for heart failure are sources of heterogeneity. Higher levels of TC, LDL-C, and HDL-C were associated with lower risk of new-onset AF. TG levels were not associated with new-onset AF in all subjects.