Long-term impact of metabolic syndrome management on mortality in patients with atrial fibrillation

초록

Background: Metabolic syndrome (MetS) is known to be associated with atrial fibrillation (AF) and cardiovascular mortality. However, it is still unclear whether the degree of Mets management is associated with allcause mortality in patients with AF. Purpose: The aim of our study was to determine the impact of the management of metabolic syndrome on mortality in patients with AF during longterm followup. Methods: This study included 5,585 consecutive AF patients (≥19 years, mean age 66±13 years, 41.1% female) in a tertiary hospital from 2007 to January 2017. The MetS was defined as diabetes plus any 2 other metabolic factors including hypertension, diabetes, dyslipidemia, and overweight. Patients were divided into three groups by degree of Mets management? wellcontrolled MetS [Group 1, n=330, patients who had optimal controls of metabolic factors with improved glycosylated hemoglobin (HbA1c), Lowdensity lipoprotein (LDL) and weight loss of 10% more], notwell controlled MetS [Group 2, n=171, one or two optimal control of metabolic factors], and poorlycontrolled MetS group [Group 3, n=107, suboptimal control of all metabolic factors]. Conclusions: Our data suggest that aggressive strategies for targeting poorly controlled Mets including optimal management of metabolic factors would be needed for longterm survival benefit in AF patients.