Abstract 1574: Individual and Joint Effects of Metabolic Syndrome Components and Risk of Incident Atrial Fibrillation in Women
Background: Atrial fibrillation (AF) is strongly associated with elevated blood pressure and obesity, two components of the metabolic syndrome (MetS). The strength of the relationship between AF and other MetS components is less well described.
Methods: Among 23,561 otherwise healthy women followed prospectively for the occurrence of atrial fibrillation, we used ATP III and AHA/NHLBI guidelines to identify women with MetS at baseline, and computed the risk of future AF according to the number and type of MetS components (elevated blood pressure, upper-body obesity, hypertriglyceridemia, low HDL, and abnormal glucose).
Results: The mean (SD) age of the 23,561 participants was 54.6 (7.0) years. At baseline, 5,327 women met the criteria for MetS, including 3,213 with 3 components of the syndrome and 2,114 with 4 or more components. During a median (inter-quartile range) follow up of 13.4 (12.8, 13.8) years, a total of 607 cases of validated incident AF (397 paroxysmal, 115 persistent, 72 chronic, 23 not specified) were reported, for an overall incidence rate of 1.99 per 1,000 person-years of observation. Presence of MetS was associated with a 39% increase in the rate of AF [fully-adjusted hazard ratio (HR) 1.39, 95% CI 1.17–1.65, P=0.0002, Table⇓], due primarily to significant increases in blood pressure (HR 1.43, 95% CI 1.20 –1.70, P<0.0001) and body mass index (HR 1.34, 95% CI 1.12–1.60, P=0.001). There were no significant increases in AF rates with elevated triglycerides (HR 0.87, 95% CI 0.73–1.04, P=0.12), low HDL-C (HR 0.98, 95% CI 0.73–1.04, P=0.85), or abnormal glucose (HR 1.21, 95% CI 0.91–1.62, P=0.20).
Conclusions: In a large population of initially healthy women, only the blood pressure and obesity components of the metabolic syndrome were significantly associated with AF risk.