Association between low-density lipoprotein cholesterol to high- density lipoprotein cholesterol ratio and atrial fibrillation in adults with chronic kidney disease

Abstract

Background: Atrial fibrillation (AF) is more common in patients with chronic kidney disease (CKD). Although a reverse relationship between lipid levels and AF has been suggested, it is uncertain if this link is relevant to CKD patients. This research investigated the association between the low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and the risk of AF in individuals with CKD. Methods: Data was collected from 21,091 non-selective, consecutive CKD patients from 2006 to December 31, 2015. We assessed the association between the LDL-C/HDL-C ratio and AF in CKD patients using binary logistic regression, along with a series of sensitivity and subgroup analyses. The dataset supporting these analyses can be accessed at:https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0230189. Results: Of the 21,091 CKD patients, 211 (1.00%) were diagnosed with AF. The cohort, predominantly male (79.93%), had a mean age of 60.89 ±10.05 years. The mean LDL-C/HDL-C ratio was 1.39±0.35. After adjusting for covariates, a significant inverse association was observed between the LDL-C/HDL-C ratio and the incidence of AF in CKD patients (OR = 0.422, 95% CI: 0.273-0.652, P = 0.00010). The robustness of these findings was confirmed through sensitivity analysis and subgroup analysis consistently showed a link between the LDL-C/HDL-C ratio and AF, suggesting that confounding factors had little effect on the LDL-C/HDL-C ratio's relationship with AF. Conclusion: Our research demonstrates an independent inverse relationship between the LDL-C/HDL-C ratio and the risk of AF in CKD patients. It is recommended to avoid overly aggressive lowering of LDL levels in CKD patients, as this may increase the risk of developing AF.