Abstract P712: Metabolic Syndrome is Associated With Risk of Ischemic Stroke in Patients With Non-Valvular Atrial Fibrillation- A National Estimate

Abstract

Objective: Primary objective of this study is to find prevalence of metabolic syndrome (MetS) in patients with acute ischemic stroke (AIS) amongst non-valvular atrial fibrillation (NVAF). Secondary aim of this study is to identify the independent components of MetS (obesity, diabetes, hypertension, high TG, low HDL), those predict AIS and compare with CHA 2 DS 2 VASc score (CHF, HTN, age>75, DM, history of stroke/TIA/thromboembolism, history of vascular disease, sex: female) amongst NVAF. Methods: A cross-sectional study was performed to identify cohort of adult hospitalization with secondary diagnosis of NVAF from Nationwide Inpatient Sample of 2008-2017. From patients with NVAF, primary hospitalization for AIS and secondary diagnosis of MetS, its components, and components of CHA 2 DS 2 VASc score were identified using ICD 9 & 10 codes. Weighed analysis using multivariable survey logistic regression was performed to evaluate the predictive potential of MetS and its components as well as to compare them with CHA2DS2VASc for AIS. Results: Amongst 33,462,134 hospitalizations with NVAF, 2.9% were due to AIS. Amongst AIS hospitalizations prevalence of MetS was 0.16% (vs 0.20%) [obesity (8.4 vs 13.7%), DM (31.6 vs 34.1%), HTN (84.3 vs 75.9%), high TG (0.4 vs 0.2%), low HDL (0.02 vs 0.02%)] in comparison to non-AIS. (p<0.001) In regression analysis, patients with MetS [aOR 1.16 (95%CI 1.04-1.30)] and its component DM [1.3 (1.3-1.4)], HTN [2.2 (2.1-2.3)], high TG [1.8 (1.7-2.0)], low HDL [1.02 (0.7-1.4) weak significant] had higher risk of AIS. Amongst CHA 2 DS 2 VASc components besides HTN and DM, history of stroke/TIA, history of vasc. disease, female and age 65-74 and >75 had higher odds of AIS (Table 1) . Conclusion: MetS and its components high TG and low HDL independently predict a high risk of AIS. Future study would evaluate whether adding of high TG and low HDL in CHA 2 DS 2 VASc score and starting anticoagulants amongst patients MetS may mitigate the risk of AIS.