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Background The purpose of this study was to evaluate the prognostic value of atrial fibrillation ( AF ) in patients with acute coronary syndrome ( ACS ). Methods A total 648 of consecutive ACS patients were divided into non‐ AF and all‐ AF groups. The all‐ AF group was further subdivided into new‐onset AF and pre‐existing AF groups. We compared prognosis among these groups using the Cox regression analysis. Results The mean follow‐up period was 1.4 ± 1.2 years. Overall patient numbers were 538 in non‐ AF and 110 in all‐ AF groups (67 in new‐onset AF and 43 in pre‐existing AF ). Seventy‐eight all‐cause deaths and 42 cardiac deaths were observed. New‐onset AF had a worse prognosis than the other groups in the Kaplan‐Meier analysis ( P = 0.025) after observation. Cox regression analysis indicated no significant difference for all‐cause death among the three groups. The hazard ratio of congestive heart failure requiring hospitalization was significantly higher in the all‐ AF and new‐onset AF group than in the non‐ AF group. Multivariate logistic regression analysis revealed that renal dysfunction, peripheral arterial disease, Killip classification ≥2, and left ventricular ejection fraction ( LVEF ) were independent predictors of all‐cause death. The new‐onset AF group had the highest prevalence of Killip classification ≥2 and the lowest LVEF . Conclusion In our study, AF was not an independent predictor of all‐cause death, but new‐onset AF may be associated with worse prognosis and future heart failure.

Objective The association between carotid atherosclerosis and the metabolic syndrome (MetS) was analyzed in the general population. The usefulness of the inclusion of the serum adiponectin concentration in the MetS criteria for the detection of atherosclerosis was also examined. Patients and MethodsThe 825 participants of a comprehensive health checkup who underwent carotid ultrasonography and the measurement of serum adiponectin levels were studied. Results The carotid plaque score (PLS) was significantly higher in the MetS group than in the non-MetS group in women, but not in men. In women, a significantly higher odds ratios was obtained for MetS, in terms of the current waist circumference criterion, and a high PLS (fourth quartile) (OR=2.64, p=0.040). In men, however, a waist circumference of around 85 cm did not reflect high a PLS, and even when the waist circumference criterion was varied, the odds ratio did not increase. When the waist circumference was replaced by hypoadiponectinemia in the current MetS criteria, the odds ratio was significantly increased in men (OR=1.82, p=0.032). Conclusion The current MetS criteria seem appropriate for women. In men, there was no significant evidence for the validity of the inclusion of the waist circumference criterion as an essential component. Incorporating hypoadiponectinemia into the current criteria would be useful for the early detection of atherosclerosis in men.