a stricter control of low-density lipoprotein is necessary for thrombosis reduction in “lower thrombosis risk” patients with atrial fibrillation: a multicenter retrospective cohort study

Patients with atrial fibrillation (af) are associated with increased thrombotic events. our previous case–control study showed low-density lipoprotein cholesterol (ldl-c) was an independent predictor of ischemic stroke in af patients. to investigate the risks of thrombosis in relation to ldl-c among af patients at different stroke risks by long-time follow-up. atrial fibrillation patients without history of thrombosis enrolled from five hospitals were classified into low-risk (lr) and high-risk (hr) group according to cha2ds2vasc score and followed up with a median period of 26 months. univariate and multivariate logistic regression analysis were performed in each group. the best cut-off value calculated by receiver operating characteristic (roc) analysis was used to divide patients into low ldl-c (l-ldl) and high ldl-c (h-ldl) subgroups. propensity score matching (psm) and inverse probability of treatment weighted (iptw) were utilized in both subgroups, after which kaplan–meier curves for thrombosis were performed. univariate and multivariate analysis showed ldl-c was significantly related to thrombosis in lr, but less significantly in hr group. the best cut-off value was 2.155 mmol/l in lr and 2.795 mmol/l in hr group. lower ldl-c was associated with decreased thrombosis in both groups by psm and iptw. kaplan–meier curves displayed that h-ldl subgroup was at higher thrombosis risk with significant difference at 24th month in lr patients. ldl-c independently predicts thrombosis with different cut-off values in af patients at different risks. a stricter control of ldl-c level is necessary for thrombosis reduction in patients with lower score.