Table 3.
Characteristics and results of the studies included in the review.
| Studies | Design | Total Cases | Population | MetS Definition | AF-MetS (% of Total Population) | Findings |
|---|---|---|---|---|---|---|
| Hyo-Jeong Ahn et al. [18], 2021 | Retrospective Cohort Study | 2.985.189 | Korean (2009–2013) (NHID) (aged > 20) | NCEP-ATPIII + modified waist circumference (WC) criteria of the Korean Society for the Study of Obesity | −14.1 | positive association of AF with the cumulative number of MetS criteria 1.46 (1.38–1.55), and 1.72 (1.63–1.82), p for trend < 0.001. HR for 3 and 4 criteria, respectively |
| Pastori et al. [27], 2021 | Prospective Cohort Study | 1.735 | Italian (mean age 75.1) Patients with a history of AF |
NCEP-ATPIII | 100–49 | MetS and NAFLD were more frequently affected by persistent/permanent AF AF combined with MetS showed a higher risk for CVEs |
| Lee et al. [25], 2021 | Retrospective Cohort Study | 7.565.531 | Korean (2008–2009) (NHID) (aged >20) | AHA/NHLBI | 1.79–36.9 | AF risk was higher by 31% in the MM group [hazard ratio (HR), 1.308; 95% CI, 1.290–1.327], 26% in the MH group (HR, 1.259; 95% CI, 1.238–1.280), and 16% in the HM group (HR, 1.155; 95% CI, 1.134–1.178) compared with the HH group, respectively |
| Wang et al. [28], 2020 | Prospective Cohort Study | 81.092 | Chinese (2006–2007) (Kailuan study) (aged 18–98) | NCEP-ATPIII | 0.3–29.8 | MS and a high hs-CRP level were associated with higher AF risk (HR = 1.61; 95% CI 1.08–2.41; p = 0.019) |
| Choe et al. [21], 2019 | Retrospective Cohort Study | 22.896.663 | Korean (2009–2012) (NHID) (aged > 40) | NCEP-ATPIII | 0.98–27.4 | HR for incident AF in patients with MetS was 1.38 (95% confidence interval [CI] 1.36–1.39) compared to those without MetS |
| Kwon et al. [26], 2019 | Retrospective Cohort Study | 7.830.602 | Korean (2009–2016) (NHID) (aged 30–69) | NCEP-ATPIII | 0.26–15.9 | Incidence of AF 0.12% in the normal group and 0.53% in the MetS group |
| Kim et al. [24], 2018 | Retrospective Cohort Study | 21.981 | Korean (2003–2008) (University Hospital of Ulsan) (mean age 46) | IDF | 0.8–11.5 | MetS was associated with an increased risk of AF. Age-adjusted HR for AF in subjects with MetS was 1.62 (95% CI 1.08–2.44, p = 0.02) |
| Nyström et al. [19], 2015 | Prospective Cohort Study | 4.021 | Swedish (1997–1999) | Revised MetS criteria of IDF [11] | 7.1–27.6 | 37.9% of the AF group had MetS vs. 26.8% of the non-AF group had MetS |
| Vyssoulis et al. [5], 2013 | Prospective Cohort Study | 15.075 | Greek (1988–2010) (aged > 40) Patients with hypertension |
NCEP-ATPIII AHA/NHLBI WHO IDF GISSI Score |
Not mentioned—from 31.7 to 47.8, according to the definition used | Presence of MS in patients with hypertension was constantly associated with a higher incidence of AF in all groups (p < 0.001). Odds ratio 1.61 to 1.99, depending on the definition of MS used |
| Chamberlain et al. [17], 2010 | Prospective Cohort Study | 15.094 | Americans (1987–1989) Atherosclerosis Risk in Communities (ARIC) Study Two groups: Black race and white race (aged 45–64) |
AHA/NHLBI | 8.2–41.1 | HR for AF among individuals with, compared to those without, the MetSyn was 1.67 (95% CI, 1.49–1.87) in both races |
| Tang et al. [20], 2009 | Retrospective Cohort Study | 741 | Chinese (2005–2007) (Mean age 55.8) |
NCEP-ATPIII | 100–46.3 | Higher prevalence of MetS in AF than that in Chinese adults (46.3% vs. 16.5%, p < 0.001) |
| Watanabe et al. [22], 2008 | Prospective Cohort Study | 28.449 | Japanese (1996–1998) (aged > 20) |
NCEP-ATPIII AHA/NHLBI |
0.9–13 (NCEP-ATPIII) 16 (AHA/NHLBI) | HR for developing AF in patients with METS was 1.88 (95% CI, 1.4–2.52) for NCEP-ATPIII and 1.61 (95% CI, 1.21–2.15) for AHA/NHLBI |
| Umetanani et al. [23], 2007 | Prospective Cohort Study | 592 | Japanese (2001–2005) (mean age 63) | NCEP-ATPIII | 5–21 | MetS was a risk factor for PAF/PAFL independently from other parameters OR 2.8, 95% confidence interval (CI) 1.3–6.2, p < 0.01) |
| Echadidi et al. [29], 2007 | Retrospective Cohort Study | 5.085 | Canadians (2000–2004) (mean age 64) After CABG |
NCEP-ATPIII | 27–46 | Incidence of AF in patients with MetS was 29% and 26% in patients without MetS (p = 0.01) |
AHA/NHLBI, American Heart Association (AHA) and the National Heart, Lung, and Blood Institute; AF, Atrial Fibrillation; ARIC, Atherosclerosis Risk in Communities; CABG, Coronary Artery Bypass Graft; CI, Confidence Interval; hs-CRP, high sensitive C reactive Protein; MetS, Metabolic Syndrome; NCEP-ATPIII, NAFLD, Non-Alcoholic Fatty Liver Disease; National Cholesterol Education Program Adult Treatment Panel III, PAF/PAFL, Paroxysmal Atrial Fibrillation/Paroxysmal Atrial Flatter; IDF GISSI; HR, Hazard Ratio.