Key result
Metabolic syndrome is linked to ~78% higher risk of new-onset AF.
Why the study?
The precise role of the metabolic syndrome in the development of atrial fibrillation was unknown.
Does metabolic syndrome increase the risk of developing atrial fibrillation in a general population without baseline AF?
Cohort (n=28,449)
Does metabolic syndrome increase the risk of developing atrial fibrillation in a general population without baseline AF?
Metabolic syndrome and its individual components significantly increase the risk of developing new-onset atrial fibrillation in a general population.
BACKGROUND: The metabolic syndrome consists of a cluster of atherosclerotic risk factors, many of which also have been implicated in the genesis of atrial fibrillation (AF). However, the precise role of the metabolic syndrome in the development of AF is unknown. METHODS AND RESULTS: This prospective, community-based, observational cohort study was based on an annual health check-up program in Japan. We studied 28 449 participants without baseline AF. We used 2 different criteria for the metabolic syndrome--the guidelines of the National Cholesterol Education Program Third Adult Treatment Panel (NCEP-ATP III) and those of the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI)--to study the risk of development of new-onset AF. The metabolic syndrome was present in 3716 subjects (13%) and 4544 subjects (16%) using the NCEP-ATP III and AHA/NHLBI definitions, respectively. During a mean follow-up of 4.5 years, AF developed in 265 subjects (105 women). Among the metabolic syndrome components, obesity (age- and sex-adjusted hazard ratio [HR], 1.64), elevated blood pressure (HR, 1.69), low high-density lipoprotein cholesterol (HR, 1.52), and impaired fasting glucose [corrected] (HR, 1.44 [NCEP-ATP III] and 1.35 [AHA/NHLBI]) showed an increased risk for AF. The association between the metabolic syndrome and AF remained significant in subjects without treated hypertension or diabetes by the NCEP-ATP III definition (HR, 1.78) but not by the AHA/NHLBI definition (HR, 1.28). CONCLUSIONS: The metabolic syndrome was associated with increased risk of AF. The metabolic derangements of the syndrome may be important in the pathogenesis of AF.
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Watanabe et al. (2008) conducted a cohort in Metabolic Syndrome and Atrial Fibrillation (n=28,449). Metabolic syndrome vs. Absence of metabolic syndrome was evaluated on New-onset atrial fibrillation (HR 1.78). Metabolic syndrome was significantly associated with an increased risk of new-onset atrial fibrillation in subjects without treated hypertension or diabetes (HR 1.78).
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