Impact of components of metabolic syndrome on the risk of adverse renal outcomes in patients with atrial fibrillation: a nationwide cohort studyopen access
- Authors
- Kwon, Soonil; Lee, So-Ryoung; Choi, Eue-Keun; Lee, Seung-Woo; Jung, Jin-Hyung; Han, Kyung-Do; Ahn, Hyo-Jeong; Oh, Seil; Lip, Gregory Y. H.
- Issue Date
- Oct-2023
- Publisher
- FRONTIERS MEDIA SA
- Keywords
- atrial fibrillation; end-stage renal disease; epidemiology; metabolic syndrome; risk factor
- Citation
- FRONTIERS IN CARDIOVASCULAR MEDICINE, v.10
- Journal Title
- FRONTIERS IN CARDIOVASCULAR MEDICINE
- Volume
- 10
- URI
- https://scholarworks.bwise.kr/ssu/handle/2018.sw.ssu/44665
- DOI
- 10.3389/fcvm.2023.1208979
- ISSN
- 2297-055X
- Abstract
- Background: The renal effect of metabolic syndrome components is unclear in patients with atrial fibrillation. This study aimed to investigate the association between metabolic syndrome components and incident end-stage renal disease among patients with atrial fibrillation.Methods: A total of 202,434 atrial fibrillation patients without prevalent end-stage renal disease were identified from the National Health Insurance Service database between 2009 and 2016. We defined the metabolic score range from 0 to 5 points such that a patient received every 1 point if the patient met each component listed in the diagnostic criteria of metabolic syndrome. The population was divided into 6 groups: MS0-MS5 for a metabolic score of 0-5, respectively. Multivariate Cox regression analysis was used to estimate the risks of end-stage renal disease.Results: There were 12,747, 31,059, 40,361, 48,068, 46,630, and 23,569 patients for MS0-MS5, respectively. Compared with MS0, MS5 had a higher CHA(2)DS(2)-VASc score (3.8 vs. 1.0) (P < .001). During a median follow-up of 3.5 years, compared with MS0, MS1-MS5 were associated with a gradually increasing incidence of end-stage renal disease, in relation to an increase in the metabolic score, (log-rank P < .001). After multivariate adjustment, a higher metabolic score was associated with a greater risk of incident end-stage renal disease: adjusted hazard ratio [95% confidence interval] = 1.60 [0.78-3.48], 2.08 [1.01-4.31], 2.94 [1.43-6.06], 3.71 [1.80-7.66], and 4.82 [2.29-10.15], for MS1-MS5, respectively.Conclusions: Metabolic syndrome components additively impacts the risk of incident end-stage renal disease among patients with atrial fibrillation.
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