Association between cardiovascular risk factors and atrial fibrillation

Guohao Wu; Jingguo Wu; Qin Lu; Yunjiu Cheng; Weiyi Mei

doi:10.3389/fcvm.2023.1110424

Association between cardiovascular risk factors and atrial fibrillation

Front Cardiovasc Med. 2023 Sep 11:10:1110424. doi: 10.3389/fcvm.2023.1110424. eCollection 2023.

Authors

Guohao Wu^#¹, Jingguo Wu^#², Qin Lu^#³, Yunjiu Cheng⁴, Weiyi Mei⁵

Affiliations

¹ Department of General Practice, Huadu District People's Hospital, Southern Medical University, Guangzhou, China.
² Department of Emergency Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
³ Department of General Practice, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
⁴ Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
⁵ Department of Cardiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

^# Contributed equally.

Abstract

Background: The most prevalent sustained arrhythmia in medical practice, atrial fibrillation (AF) is closely associated with a high risk of cardiovascular disease. Nevertheless, the risk of AF associated with cardiovascular risk factors has not been well elucidated. We pooled all published studies to provide a better depiction of the relationship among cardiovascular risk factors with AF.

Methods: Studies were searched in the MEDLINE, Web of Science, and EMBASE databases since initiation until January 15, 2022. Prospective cohort studies assessing the relationship a minimum of single cardiovascular risk factors to AF incidence were included if they contained adequate data for obtaining relative risks (RR) and 95% confidence intervals (CI). Random-effects models were utilized to perform independent meta-analyses on each cardiovascular risk factor. PROSPERO registry number: CRD42022310882.

Results: A total of 17,098,955 individuals and 738,843 incident cases were reported for data from 101 studies included in the analysis. In all, the risk of AF was 1.39 (95% CI, 1.30-1.49) for obesity, 1.27 (95% CI, 1.22-1.32) per 5 kg/m² for increase in body mass index, 1.19 (95% CI, 1.10-1.28) for former smokers, 1.23 (95% CI, 1.09-1.38) for current smokers, 1.31 (95% CI, 1.23-1.39) for diabetes mellitus, 1.68 (95% CI, 1.51-1.87) for hypertension, and 1.12 (95% CI, 0.95-1.32) for dyslipidemia.

Interpretation: Adverse cardiovascular risk factors correlate with an increased risk of AF, yet dyslipidemia does not increase the risk of AF in the general population, potentially providing new insights for AF screening strategies among patients with these risk factors.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, PROSPERO identifier (CRD42022310882).

Keywords: association; atrial fibrillation; cardiovascular risk factors; meta-analysis and systematic review; prospective cohort studies.

Publication types

Review

Grants and funding

The study was also financially supported by the grants from National Natural Science Foundation of China (81600260, 82270333), Guangdong Basic and Applied Basic Research Foundation (2021A1515010405, 2022A1515012358), and High-level Talents Introduction Plan of Guangdong Provincial People's Hospital (KY012023007). The funders of this research did not take part in research conception, literature screening, data extraction, statistical analysis, results discussion, or report preparation.