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Metabolic Syndrome Associated With Increased Risks of Atrial Fib and Stroke


 

BARCELONA — Patients with metabolic syndrome have an increased risk of developing atrial fibrillation compared with patients with a single risk factor for cardiovascular disease, based on an analysis of more than 13,000 patients.

Metabolic syndrome also boosted the risk of stroke in patients with atrial fibrillation (AF) compared with patients with AF and a single cardiovascular-disease risk factor, Dr. Leonardo Tamariz and his associates reported in a poster at a joint meeting of the European Society of Cardiology and the World Heart Federation.

The study analyzed data for 13,200 patients with AF who were drawn from the records of more than 380,000 patients insured through Humana Inc. in the United States and who were diagnosed with at least one cardiovascular risk factor during January 2003-May 2004. The included risk factors were hypertension, obesity, diabetes, and lipid abnormalities. Patients are diagnosed with metabolic syndrome if they have three or more of these risk factors.

The prevalence of AF was significantly linked to the number of risk factors that patients had. (See box.) In a multivariate analysis that controlled for age, gender, coronary artery disease, and heart failure, patients with all four risk factors were 40% more likely to have AF compared with patients with one risk factor, reported Dr. Tamariz, an internal medicine physician at the University of Miami. The prevalence of AF in patients with three risk factors was not significantly higher than in patients with one risk factor.

Patients with metabolic syndrome also developed AF at a younger age. Among patients with a single cardiovascular disease risk factor, the average age of patients with AF was 73 years. Patients with two risk factors developed AF at an average age of 71 years, those with three risk factors had AF at age 67 years, and those with four risk factors and AF had an average age of 60 years.

The researchers also analyzed the prevalence of stroke by number of risk factors in patients with AF. Generally, the more risk factors a patient had, the higher the risk of stroke.

In a multivariate analysis that controlled for age, gender, coronary artery disease, and heart failure, patients with three risk factors had the highest stroke prevalence, 2.8-fold higher than patients with a single risk factor; those with four risk factors had a 2.2-fold higher stroke prevalence than those with one factor.

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