Dyslipidemia in patients with atrial fibrillation on the background of acute coronary syndrome according to the register of the Krasnodar region
https://doi.org/10.35401/2500-0268-2019-15-3-19-24
Abstract
Aim. Atrial fibrillation (AF) is connected with the increased risk of stroke, mortality rate and costs for health care around the world. Earlier the predictive role of a dyslipidemia was not estimated in available literature.
Material and methods. This retrospective study included 13,244 patients who consistently referred to Scientific Research Institute – Regional Clinical Hospital no. 1, Krasnodar, with acute coronary syndrome from November 20, 2015 to November 20, 2017. Primary final points were defined both as mortality from all reasons and from the cardiovascular events. Secondary final points were defined as repeated myocardial infarction. Follow up period was 12 months.
Results. In the studied group ACS + AF we included 201 patients. This group of patients was divided into 3 subgroups: patients with originally developed AF episode accompanied with acute coronary syndrome, included 52 patients (Group 1), patients with constant AF form, included 96 patients (Group 2) and patients with paroxysmal or persistent atrial fibrillation registered before ACS episode, included 53 patients (Group 3). In Group 1 the level of the general cholesterol and low-density lipoproteins (LDL) was authentically higher. Among the survived and discharged patients after ACS episode there were 45 patients in Group 1, in Group 2 and 3 there were 81 and 47 patients, respectively. In 12 months the general mortality rate was comparable, however, the frequency of lethal and non-lethal myocardial infarction development was authentically higher in Group 1.
Conclusions. Higher initial levels of the general cholesterol and LDL are connected with development repeated MI that does not affect the general mortality rate. However, these data are obtained in a small selection of patients and demand a further investigation.
About the Authors
Z. G. Tatarintseva
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1
Russian Federation
Russian Federation
Tatarintseva Zoya G. – Head of Cardiologic Department no. 4
350086, Krasnodar, 1st May street, 167
E. D. Kosmacheva
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1;
Kuban State Medical University
Russian Federation
Russian Federation
Kosmacheva Elena D. – Dr. of Sci. (Med.), Chief Medical Officer; Head of Department of Therapy no. 1 ATF
References
1. Chugh SS, Havmoeller R, Narayanan K., et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation. 2014;25;129(8):837-47. doi: 10.1161/CIRCULATIONAHA.113.005119.
2. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;7;37(38):2893- 2962. doi: 10.1093/eurheartj/ehw210.
3. Hijazi Z, Oldgren J, Lindbäck J, et al. A biomarkerbased risk score to predict death in patients with atrial fibrillation: the ABC (age, biomarkers, clinical history) death risk score. Eur Heart J. 2018;7;39(6):477-485. doi: 10.1093/eurheartj/ehx584.
4. Hijazi Z, Wallentin L, Siegbahn A, et al. High-sensitivity troponin T and risk stratification in patients with atrial fibrillation during treatment with apixaban or warfarin. J Am Coll Cardiol. 2014;7-14;63(1):52-61. doi: 10.1016/j.jacc.2013.07.093.
5. Hijazi Z, Wallentin L, Siegbahn A, et al. N-terminal pro-B-type natriuretic peptide for risk assessment in patients with atrial fibrillation: insights from the ARISTOTLE Trial (Apixaban for the Prevention of Stroke in Subjects With Atrial Fibrillation). J Am Coll Cardiol. 2013;4;61(22):2274-84. doi: 10.1016/j.jacc.2012.11.082.
6. Scirica BM, Braunwald E, Raz I, et al. Heart failure, saxagliptin, and diabetes mellitus: observations from the SAVORTIMI 53 randomized trial. Circulation. 2014;28;130(18):1579-88. doi: 10.1161/CIRCULATIONAHA.114.010389.
7. Hu YF, Chen YJ, Lin YJ, Chen SA. Inflammation and the pathogenesis of atrial fibrillation. Nat Rev Cardiol. 2015;12(4):230-43. doi: 10.1038/nrcardio.2015.2.
8. Dutta P, Courties G, Wei Y, et al. Myocardial infarction accelerates atherosclerosis. Nature. 2012;19;487(7407):325-9. doi: 10.1038/nature11260.
9. Wong ND. Epidemiological studies of CHD and the evolution of preventive cardiology. Nat Rev Cardiol. 2014;11(5):276-89. doi: 10.1038/nrcardio.2014.26.
10. Ference BA, Ginsberg HN, Graham I, et al. Lowdensity lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J. 2017;21;38(32):2459-2472. doi: 10.1093/eurheartj/ehx144.
11. Shadi Yaghi, Mitchell SV. Elkind Lipids and Cerebrovascular Disease: Research and Practice. Stroke. 2015;46(11):3322-3328. doi: 10.1161/STROKEAHA.115.011164.
12. Zhao YY, Cheng XL, Vaziri ND, et al. UPLC-based metabonomic applications for discovering biomarkers of diseases in clinical chemistry. Clin Biochem. 2014;47(15):16-26. doi: 10.1016/j.clinbiochem.2014.07.019.
13. Alonso A, Yin X, Roetker NS, et al. Blood lipids and the incidence of atrial fibrillation: the Multi-Ethnic Study of Atherosclerosis and the Framingham Heart Study. J Am Heart Assoc. 2014(7);3(5):e001211. doi: 10.1161/JAHA.114.001211.
14. Faye L. Lopez, Sunil K. Agarwal, et al. Blood Lipid Levels, Lipid Lowering Medications, and the Incidence of Atrial Fibrillation: The Atherosclerosis Risk in Communities (ARIC) Study. Circ Arrhythm Electrophysiol. 2012(1);5(1):155-162. doi: 10.1161/CIRCEP.111.966804.
15. Watanabe H, Tanabe N, Yagihara N, et al. Association between lipid profile and risk of atrial fibrillation. Circ J. 2011;75(12):2767-74.
16. Mora S, Akinkuolie AO, Sandhu RK, et al. Paradoxical association of lipoprotein measures with incident atrial fibrillation. Circ Arrhythm Electrophysiol. 2014;7(4):612-9. doi: 10.1161/CIRCEP.113.001378.
17. Norby FL, Eryd SA, Niemeijer MN, et al. Association of Lipid-Related Genetic Variants with the Incidence of Atrial Fibrillation: The AFGen Consortium. PLoS One. 2016(21);11(3):e0151932. doi: 10.1371/journal.pone.0151932.
18. Annoura M, Ogawa M, Kumagai K, et al. Cholesterol paradox in patients with paroxysmal atrial fibrillation. Cardiology. 1999;92(1):21-7. doi: 10.1159/000006942/
19. Lopez FL, Agarwal SK, Maclehose RF, et al. Blood lipid levels, lipid-lowering medications, and the incidence of atrial fibrillation: the atherosclerosis risk in communities study. Circ Arrhythm Electrophysiol. 2012;5(1):155–62. doi: 10.1161/CIRCEP.111.966804.
20. Alonso A, Yin X, Roetker NS, et al. Blood lipids and the incidence of atrial fibrillation: the Multi-Ethnic Study of Atherosclerosis and the Framingham Heart Study. J Am Heart Assoc. 2014;3(5):e001211. doi: 10.1161/JAHA.114.001211.
21. Norby FL, Eryd SA, Niemeijer MN, et al. Association of lipid-related genetic variants with the incidence of atrial fibrillation: The AFGen consortium. PLoS One. 2016;11(3):e0151932. doi: 10.1371/journal.pone.0151932.
22. Liu YB, Wu CC, Lee CM, et al. Dyslipidemia is associated with ventricular tachyarrhythmia in patients with acute ST-segment elevation myocardial infarction. J Formos Med Assoc. 2006;105(1):17-24. doi: 10.1016/S0929-6646(09)60104-2.
23. Saini HK, Arneja AS, Dhalla NS. Role of cholesterol in cardiovascular dysfunction. Can J Cardiol. 2004;20(3):333-346.
24. Renato JA, Rodrigo NC, Kenji N. Choronic and regular use of statin prevents atrial fibrillation in period after cardiac surgery. Arq Bras Cardiol. 2010;95(5):614-620. doi: 10.1590/S0066-782X2010005000129.
25. Aydin M, Susam I, Kilicaslan B, et al. Serum cholesterol levels and postoperative atrial fibrillation. J Cardiothorac Surg. 2014;9:69. doi: 10.1186/1749-8090-9-69.
26. Mann DM, Glazer NL, Winter M, et al. A pilot study identifying statin nonadherence with visit-to-visit variability of low-density lipoprotein cholesterol. Am J Cardiol. 2013;111(10):1437-42. doi: 10.1016/j.amjcard.2013.01.297.
Review
For citations:
Tatarintseva Z.G., Kosmacheva E.D. Dyslipidemia in patients with atrial fibrillation on the background of acute coronary syndrome according to the register of the Krasnodar region. Innovative Medicine of Kuban. 2019;(3):19-24. (In Russ.) https://doi.org/10.35401/2500-0268-2019-15-3-19-24
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