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(Circulation. 2008;117:1247.)
© 2008 American Heart Association, Inc.

Clinical Summaries

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Metabolic Syndrome and Risk of Development of Atrial Fibrillation: The Niigata Preventive Medicine Study

 
The metabolic syndrome and atrial fibrillation (AF) are common disorders, and the prevalence of both disorders is currently increasing with a growing elderly population and changing lifestyle. Because many of the components of the metabolic syndrome also are risk factors for the development of AF, an association between the metabolic syndrome and AF has been proposed. Furthermore, inflammation and oxidative stress have been implicated in the pathogenesis of both the metabolic syndrome and AF. Therefore, we studied the association between the metabolic syndrome and new-onset AF in the general population. In the present study, subjects meeting the criteria for the metabolic syndrome were at increased risk of development of AF. Among the components of the metabolic syndrome, obesity, elevated blood pressure, impaired glucose tolerance, and reduced high-density lipoprotein cholesterol, but not elevated triglycerides, were associated with AF. The risk of developing AF increased across a number of the fulfilled metabolic syndrome components. Our data suggest that the metabolic syndrome increases not only the risk of atherosclerotic diseases but also the risk of AF. It is likely that an interaction between the metabolic syndrome and deranged biochemical indexes activates signaling pathways important in the pathogenesis of AF. Modulation of the pathways may be of therapeutic value for preventing AF. See p 1255.

	Cost-Effectiveness of Providing Full Drug Coverage to Increase Medication Adherence in Post–Myocardial Infarction Medicare Beneficiaries

 
Effective therapies for the secondary prevention of coronary heart disease–related events are significantly underused, and attempts to improve adherence have often yielded disappointing results. Elimination of patient out-of-pocket costs may be an effective strategy to enhance medication use. . . . [Full Text of this Article]