Metabolic Syndrome and Atrial Cardiomyopathy on the Risk of Stroke Mortality in the General Population
Yaodongqin Xia1,2, Xuan Lu3, Minglong Chen1
1Division of Cardiology, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China.
Insights
Metabolic syndrome (MetS) and atrial cardiomyopathy (AtCM) significantly increase stroke mortality risk, especially when occurring together. Individuals with both conditions face the highest risk, highlighting the need for targeted interventions.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Metabolic syndrome (MetS) and atrial cardiomyopathy (AtCM) are established risk factors for cardiovascular diseases, including stroke.
- Understanding their combined impact on stroke mortality is crucial for risk stratification and prevention strategies.
Purpose of the Study:
- To investigate the combined effect of Metabolic syndrome and atrial cardiomyopathy on stroke mortality.
- To determine the stroke mortality risk associated with different combinations of MetS and AtCM status.
Main Methods:
- Analysis of data from the Third National Health and Nutrition Examination (NHANES III) Survey.
- MetS defined by ATP III criteria; AtCM defined by deep terminal negativity of the P wave in V1 (DTNPV1).
- Survey-weighted Firth penalized Cox analysis to assess stroke mortality risk across MetS-AtCM categories.
Main Results:
- A total of 4315 participants were analyzed.
- Stroke mortality rates increased progressively with combined MetS and AtCM: MHNA (1.56), MUNA (2.78), MHA (4.68), and MUA (8.24 per 1000 person-years).
- Metabolically unhealthy with AtCM (MUA) showed a significantly higher risk of stroke mortality (HR=3.33, p=0.018) compared to metabolically healthy without AtCM (MHNA).
Conclusions:
- A joint association between Metabolic syndrome and atrial cardiomyopathy significantly increases stroke mortality risk.
- Further research, including randomized controlled trials, is needed to explore anticoagulation efficacy in high-risk individuals with both MetS and AtCM.
Introduction:
Metabolic syndrome (MetS) and atrial cardiomyopathy (AtCM) are recognized as risk factors for cardiovascular disease, including stroke. We aimed to determine the combined impact of MetS and AtCM on stroke mortality.
Methods:
Participants were selected from the Third National Health and Nutrition Examination (NHANES III) Survey. MetS was defined according to the Adult Treatment Panel III, while AtCM was defined as deep terminal negativity of the P wave in V1 (DTNPV1). Survey-weighted Firth penalized Cox analysis was performed to determine the adjusted HRs and 95% CIs of stroke mortality by MetS-AtCM status, including metabolically healthy without AtCM (MHNA; reference), metabolically unhealthy without AtCM (MUNA), metabolically healthy with AtCM (MHA), metabolically unhealthy with AtCM (MUA).
Results:
A total of 4315 participants were included in the analysis. Throughout the follow-up, the rates of stroke mortality increased across the MetS-AtCM status categories: 1.56, 2.78, 4.68, and 8.24 per 1000 person-years in MHNA, MUNA, MHA, and MUA groups, respectively. Compared to the MHNA participants, MUA were at a higher risk of stroke mortality (HR = 3.33, 95% CI 1.24-8.94, p = 0.018). Stroke mortality showed a non-significant upward trend in both MUNA (HR = 1.57, 95% CI 0.96-2.59, p = 0.074) and MHA (HR = 1.61, 95% CI 0.52-5.00, p = 0.401) groups.
Conclusions:
Our findings suggest a potential joint association of MetS and AtCM on stroke mortality. Further RCTs are warranted to evaluate the efficacy of anticoagulation in preventing ischemic stroke and reducing stroke mortality among individuals with both MetS and AtCM.
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