Arrhythmias & electrophysiologyMeta-analysis
Prediabetes and the risk of atrial fibrillation: systematic review, meta-analysis, and dose–response meta-analysis
- Systematic review and dose–response meta-analysis of observational studies
- random-effects
Authors' conclusion
Prediabetes is associated with a modest but statistically significant increase in AF risk, with evidence of a dose-dependent relationship across the glycemic spectrum.
Study context
- Population
- Adults with prediabetes vs normoglycemic controls
- Participants
- 26.4 million adults · 15 cohort studies
- Comparison
- Prediabetes vs normoglycemia
- Outcome
- Incident or prevalent AF
Pooled result
AF
Pooled hazard ratio
1.15
95% CI 1.04–1.27
Prediabetes vs Normoglycemia
pooled HR 1.15 (95% CI 1.04–1.27)
As reported in the abstract
Further pooled results
| Outcome | HR (95% CI) | |
|---|---|---|
| AF risk by geographic region (subgroup) — Prediabetes vs Normoglycemia · East Asian populations | 1.22 (1.05–1.42) | |
| AF risk by geographic region (subgroup) — Prediabetes vs Normoglycemia · European populations | 1.08 (0.97–1.20) | |
| 0.512Hazard ratio (log scale) |
Atrial fibrillation (AF) risk by geographic region (subgroup)
- Association consistent across prediabetes definitions, sexes, age groups and publication era
FPG dose-response
- Increase in AF risk per mg/dL FPG
- approximately 0.4%
Publication bias
- Egger's test non-significant
- P = 0.454
- Trim-and-fill adjusted estimate, HR
- 1.36 (95% CI 1.20-1.53)
Original publication
Prediabetes and the risk of atrial fibrillation: systematic review, meta-analysis, and dose–response meta-analysis. Eur J Prev Cardiol. Published 16 April 2026. doi:10.1093/eurjpc/zwag215
Summarised from the published abstract; every number is checked against it