Korean J Crit Care Med.  2011 Mar;26(1):6-12. 10.4266/kjccm.2011.26.1.6.

Metabolic Syndrome as a Risk Factor for Atrial Fibrillation in Patients with Acute Myocardial Infarction

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea. medsws@catholic.ac.kr
  • 2Division of Cardiology, Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
  • 3Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.

Abstract

BACKGROUND
Atrial fibrillation (AF) has been linked to an increased risk for in-hospital and long-term mortality rates in patients with acute myocardial infarction (AMI). Obesity and metabolic syndrome (MS) are known to play an important role in cardiovascular morbidity and mortality. However, it is uncertain whether obesity and MS increase the risk of AF in patients with AMI. Therefore, we investigated independent risk factors for the occurrence of new-onset AF in patients with AMI who received optimal percutaneous coronary intervention (PCI).
METHODS
We prospectively analyzed the association between MS and the incidence of cardiac arrhythmia in 146 patients with AMI who underwent PCI. Twenty-four-hour Holter monitoring was performed 3 days after AMI. We divided the patients into two different groups based on the development of AF and analysed their obesity based on body mass index (BMI) (kg/m2) and evaluated the existence of MS, as well as visceral obesity with fat computed tomography.
RESULTS
Seventy-five patients (51.4%) were obese (BMI > or = 25) and 64 (44%) had MS. AF occurred in 33 (22.6%) patients. Age, MS, and visceral obesity were significantly associated with AF (p = 0.001, p = 0.003, and p = 0.03, respectively). There was no difference between obese and non-obese patients in the incidence of AF and VT. Multivariate analysis revealed that age and MS were independent risk factors of post-AMI AF.
CONCLUSIONS
MS is an important and modifiable risk factor for new-onset AF especially in patients with AMI who underwent PCI.

Keyword

arrhythmia; metabolic syndrome; myocardial infarction

MeSH Terms

Arrhythmias, Cardiac
Atrial Fibrillation
Body Mass Index
Electrocardiography, Ambulatory
Humans
Incidence
Multivariate Analysis
Myocardial Infarction
Obesity
Obesity, Abdominal
Percutaneous Coronary Intervention
Prospective Studies
Risk Factors
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