Key points are not available for this paper at this time.
Background: Atrial fibrillation/flutter (AF) is increasingly prevalent, and identification of modifiable risk factors is a priority. Zinc deficiency (ZD) has been implicated in cardiovascular disease, but large-scale evidence linking ZD to incident AF remains limited. Methods: = 61,732) or zinc-sufficient (70-120 μg/dL, n = 61,732) after 1:1 propensity score matching. The primary outcome was newly diagnosed AF within two years after the index date. The secondary outcomes included risks of pneumonia (positive control), ventricular fibrillation/flutter, and ischemic stroke. Outcome events were stratified into early and late onset, defined as those occurring within 1-6 months and 6-24 months, respectively. Results: < 0.001). A clear dose-response relationship was observed when comparing different levels of ZD to the control group. Severe ZD (< 50 μg/dL) conferred nearly two-fold higher late AF risk vs. controls (HR 2.04, 95% CI 1.67-2.49), while mild-to-moderate ZD (50-70 μg/dL) showed a modest but significant increase compared to controls (HR 1.26, 95% CI 1.14-1.41). The association between ZD and AF remained consistent across diverse patient subgroups and both pre-pandemic (2010-2019) and pandemic periods (2020-2023). The risks of pneumonia (early: HR 1.56; late: HR 1.40) and ischemic stroke (early: HR 1.19; late: HR 1.12) were also elevated in zinc-deficient patients, whereas ventricular fibrillation/flutter was not significantly associated with ZD. Conclusion: ZD may serve as an important independent risk factor for incident AF, highlighting the potential value of incorporating zinc status into cardiovascular risk assessment and considering zinc supplementation as a cost-effective preventive strategy.
Chen et al. (2026) studied this question.