Author + information
- Konstantinos N. Aronis,
- Di Zhao,
- Ron Hoogeveen,
- Alvaro Alonso,
- Christie Ballantyne,
- Eliseo Guallar,
- Steven Jones,
- Seth Martin,
- Saman Nazarian,
- Salim Virani and
- Erin Michos
Background: Lp(a) is pro-atherosclerotic and pro-thrombotic, causal of coronary disease, and associated with other cardiovascular diseases. The association of Lp(a) with atrial fibrillation (AF) and stroke among individuals with AF remains to be elucidated.
Methods: Lp(a) levels were measured at baseline (ARIC visit 4, 1996-8). Multivariable adjusted Cox models (see figure for covariates) were used to compare AF and stroke risk across Lp(a) levels. First aim: incident AF was evaluated in 9,908 participants free of AF at baseline. AF was ascertained by ECGs at study visits, hospital discharge ICD-9 codes and death certificates. Second aim: incident stroke was evaluated in 9,944 participants free of stroke at baseline. Stroke was identified by annual phone calls and hospital ICD-9 codes. Results were stratified by history of AF.
Results: Baseline age was 62.7±5.6 yrs. Median (IQR) Lp(a) was 13.3 (5.2-39.7) mg/dL. Mean follow-up was 12.6 and 14.2 yrs for the AF and stroke aims. In participants with Lp(a) ≥ 50, compared to those with <10 mg/dL: Lp(a) was not associated with incident AF [HR 1.02 (95% CI 0.86-1.21), Figure A]. Lp(a) was associated with a 46% relative increase in stroke risk among participants without AF [1.46 (1.10-1.94), Figure B] but not with [0.99 (0.65-1.52), Figure C]; p-interaction 0.15.
Conclusions: Lp(a) levels are not associated with incident AF, even in participants at the highest Lp(a) category. Lp(a) levels are associated with increased stroke risk, primarily in individuals without AF.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Arrhythmias and Clinical EP: AF Miscellaneous and Surgical Issues
Abstract Category: 6. Arrhythmias and Clinical EP: Other
Presentation Number: 1236-091
- 2017 American College of Cardiology Foundation