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.