Metabolic syndrome, high-sensitivity C-reactive protein levels and the risk of new-onset atrial fibrillation: Results from the Kailuan Study

Background and aims Some studies have reported that metabolic syndrome (MS) and a high inflammatory state are risk factors for atrial fibrillation (AF). However, the combined effect of MS and a high inflammatory state on AF is still unknown. We aimed to investigate the association of MS and high-sensitivity C-reactive protein (hs-CRP) levels with the risk of AF in a large community-based population. Methods and results A total of 81,092 subjects from the Kailuan Study with electrocardiogram examination and hs-CRP data at baseline (1st examination, 2006–2007) were included in this study. The enrolled population was divided into 4 groups according to the presence or absence of metabolic syndrome and high hs-CRP (>3 mg/L). The follow-up examinations were performed every two years (2nd examination, 2008–2009; 3rd examination, 2010–2011; 4th examination, 2012–2013; 5th examination, 2014–2015). All participants were followed until the occurrence of AF or the date of the last examination. After a mean time of 7.2 ± 2.0 years, a total of 271 individuals developed incident AF. MS or high hs-CRP alone was not associated with incident AF after multivariable adjustment. However, multiple Cox regression analysis showed that subjects with MS and hs-CRP > 3 mg/L had a greater risk for AF than those without MS and with hs-CRP ≤ 3 mg/L (hazard ratio, 1.61; 95% confidence interval 1.08–2.41; P = 0.019). Conclusion MS combined with a high hs-CRP level is associated with an increased risk for AF in the Chinese population. However, the mechanism is unknown and awaits further study. Trial registration site http://www.chictr.org.cn/index.aspx. Registration number ChiCTR-TNRC-11001489.