Lipids & metabolic liver disease
Relation of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio to residual risk in anticoagulated patients with atrial fibrillation: a report from the prospective Murcia atrial fibrillation (AF) Project III cohort
Authors' conclusion
In anticoagulated AF patients, high NHHR was independently associated with increased residual thromboembolic and cardiovascular risk. NHHR may improve cardiovascular risk stratification in patients with AF, although external validation in more ethnically diverse cohorts is warranted.
Study context
- Population
- Consecutive AF outpatients initiating oral anticoagulation (OAC), January 2016–November 2021; 52.8% female; age 76 years [IQR 69–82]
- Participants
- 1,694 outpatients
- Exposure
- High vs low NHHR
- Outcome
- Thromboembolic events (composite of ischaemic stroke, transient ischaemic attack (TIA) or systemic embolism) and MACE (MI, ischaemic stroke, TIA or cardiovascular death)
- Follow-up
- 1.86 years [SD 0.4]
Methodological detailsconsecutive outpatients, multivariable Cox models, restricted cubic spline models
- Consecutive outpatients
- Multivariable Cox models
- Restricted cubic spline models
Main finding
As reported in the abstract
Each group vs low NHHREstimate (95% CI)P value
High NHHR
aHR (thromboembolic events) 2.15(1.41–3.29)
P < 0.001High NHHR
aHR (MACE) 1.69(1.15–2.48)
P = 0.007- Thromboembolic event, whole cohort
- 97 (5.7%)
- Major adverse cardiovascular events (MACE), whole cohort
- 126 (7.4%)
- Significant linear associations between continuous NHHR and primary outcomes (restricted cubic spline (RCS))
- p-overall < 0.001
Observational data: associations, not effects.
Secondary outcomes
Cardiovascular and all-cause death
- No significant associations observed for secondary outcomes
Original publication
Relation of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio to residual risk in anticoagulated patients with atrial fibrillation: a report from the prospective Murcia AF Project III cohort. Cardiovasc Diabetol. Published 30 September 2025. doi:10.
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