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Relationship between lipoproteins, thrombosis and atrial fibrillation.

Ding, WY, Protty, MB, Davies, IG and Lip, GYH (2021) Relationship between lipoproteins, thrombosis and atrial fibrillation. Cardiovascular Research. ISSN 0008-6363

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Abstract

The prothrombotic state in atrial fibrillation (AF) occurs as a result of multifaceted interactions, known as Virchow's triad of hypercoagulability, structural abnormalities and blood stasis. More recently, there is emerging evidence that lipoproteins are implicated in this process, beyond their traditional role in atherosclerosis. In this review, we provide an overview of the various lipoproteins and explore the association between lipoproteins and AF, the effects of lipoproteins on haemostasis, and the potential contribution of lipoproteins to thrombogenesis in AF. There are several types of lipoproteins based on size, lipid composition and apolipoprotein category, namely: chylomicrons, very low density lipoprotein, low density lipoprotein (LDL), intermediate density lipoprotein and high density lipoprotein. Each of these lipoproteins may contain numerous lipid species and proteins with a variety of different functions. Furthermore, the lipoprotein particles may be oxidised causing an alteration in their structure and content. Of note, there is a paradoxical inverse relationship between total cholesterol and LDL-C levels, and incident AF. The mechanism by which this occurs may be related to the stabilising effect of cholesterol on myocardial membranes, along with its role in inflammation. Overall, specific lipoproteins may interact with haemostatic pathways to promote excess platelet activation and thrombin generation, as well as inhibiting fibrinolysis. In this regard, LDL-C has been shown to be an independent risk factor for thromboembolic events in AF. The complex relationship between lipoproteins, thrombosis and AF warrants further research with an aim to improve our knowledge base and contribute to our overall understanding of lipoprotein-mediated thrombosis.

Item Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Cardiovascular Research following peer review. The version of record Wern Yew Ding, Majd B Protty, Ian G Davies, Gregory Y H Lip, Relationship between lipoproteins, thrombosis, and atrial fibrillation, Cardiovascular Research, 2021;, cvab017, is available online at: https://dx.doi.org/10.1093/cvr/cvab017
Uncontrolled Keywords: 1102 Cardiorespiratory Medicine and Haematology
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC1200 Sports Medicine
R Medicine > RM Therapeutics. Pharmacology
Divisions: Sport & Exercise Sciences
Publisher: Oxford University Press (OUP)
Related URLs:
Date Deposited: 02 Mar 2021 10:52
Last Modified: 02 Mar 2021 11:00
DOI or Identification number: 10.1093/cvr/cvab017
URI: https://researchonline.ljmu.ac.uk/id/eprint/14541

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