Association between LDL-C/HDL-C ratio and atrial fibrillation risk in chronic heart failure patients

Lipid levels are negatively correlated with atrial fibrillation (AF) in the general population. We aimed to investigate the correlation between low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio and AF in chronic heart failure (CHF). We enrolled 1,294 consecutive CHF patients. The LDL-C/HDL-C ratio was categorized into quartiles: Q1 (< 1.80), Q2 (1.80–2.43), Q3 (2.44–3.29), and Q4 (> 3.29). The relationship between the LDL-C/HDL-C ratio and AF in patients with CHF was analyzed by univariate and multivariate analyses through binary logistic regression, and sensitivity and subgroup analyses were performed for the multivariate results to validate the robustness of the multivariate results and assess the influence of confounding variables. The LDL-C/HDL-C ratio was inversely associated with the prevalence of AF in patients with CHF. When modeled by quartiles as a categorical variable, the trend P -value remained consistent with the continuous analysis. Sensitivity analyses excluding patients with stroke, dilated cardiomyopathy, or atherosclerosis confirmed the association (full model P for trend < 0.05), indicating robust results. In subgroup analyses, the association was not significantly influenced by confounding variables ( P for interaction > 0.05). The LDL-C/HDL-C ratio was independently and inversely associated with prevalent AF among patients with chronic heart failure. This readily available metric may help identify CHF patients who could benefit from enhanced AF screening.