Giuseppe Boriani1, Cécile Laroche2, Igor Diemberger3, Elisa Fantecchi1, Joan Meeder4, Malgorzata Kurpesa5, Monica Mariana Baluta6, Marco Proietti7, Luigi Tavazzi8, Aldo P Maggioni2,9, Gregory Y H Lip7,10. 1. Cardiology Department, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy. 2. EURObservational Research Programme Department, European Society of Cardiology, Sophia Antipolis, France. 3. Institute of Cardiology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, S. Orsola-Malpighi University Hospital, Bologna, Italy. 4. Department of Cardiology, VieCuri Medical Center, Venlo, the Netherlands. 5. Cardiology Department, Medicał University, Lodz, Poland. 6. Cardiology Department, Carol Davila University of Medicine and Pharmacy, St. Pantelimon Emergency Hospital, Bucharest, Romania. 7. University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom. 8. Maria Cecilia Hospital, GVM Care&Research. E.S. Health Science Foundation, Cotignola, Italy. 9. ANMCO Research Center, Firenze, Italy. 10. Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Abstract
BACKGROUND: The impact of overweight and obesity on outcomes in "real world" patients with atrial fibrillation (AF) is not fully defined. Second, sex differences in AF outcomes may also exist. METHODS AND RESULTS: The aim was to investigate outcomes at 1 year follow-up for AF patients enrolled in the EORP-AF Registry, according to BMI (kg/m2 ), comparing patients with normal BMI (18.5 to < 25 kg/m2 ), overweight (25 to < 30 kg/m2 ) and obesity (≥ 30 kg/m2 ), in relation to sex differences. Among 2,540 EORP AF patients (38.9% female; median age 69) with 1 year follow-up data available, 720 (28.3%) had a normal BMI, 1,084 (42.7%) were overweight, and 736 (29.0%) were obese. Obese patients were younger and with more prevalent diabetes mellitus and hypertension (P < 0. 001). One-year outcomes showed that all-cause mortality was significantly different according to BMI among female patients (9.3% normal BMI, 5.3% overweight, and 4.3 % obese, P = 0.023), but not among male patients (P = 0.748). The composite outcome of thromboembolic events and death was also significantly different, being lower in obese females (P = 0.035). Among male patients, bleeding events were significantly more frequent in obese subjects (P = 0.035). On multivariable Cox analysis, BMI was not independently associated with all-cause mortality. CONCLUSIONS: Among AF patients, overweight and obesity are common and associated with better outcomes in females (a finding previously reported as "obesity paradox"), while no significant differences in outcomes are detected among male patients. Final multivariable model found that increasing BMI was not associated with increased risk of all-cause death; conversely, age and comorbidities persisted as major determinants.
BACKGROUND: The impact of overweight and obesity on outcomes in "real world" patients with atrial fibrillation (AF) is not fully defined. Second, sex differences in AF outcomes may also exist. METHODS AND RESULTS: The aim was to investigate outcomes at 1 year follow-up for AFpatients enrolled in the EORP-AF Registry, according to BMI (kg/m2 ), comparing patients with normal BMI (18.5 to < 25 kg/m2 ), overweight (25 to < 30 kg/m2 ) and obesity (≥ 30 kg/m2 ), in relation to sex differences. Among 2,540 EORP AFpatients (38.9% female; median age 69) with 1 year follow-up data available, 720 (28.3%) had a normal BMI, 1,084 (42.7%) were overweight, and 736 (29.0%) were obese. Obesepatients were younger and with more prevalent diabetes mellitus and hypertension (P < 0. 001). One-year outcomes showed that all-cause mortality was significantly different according to BMI among female patients (9.3% normal BMI, 5.3% overweight, and 4.3 % obese, P = 0.023), but not among male patients (P = 0.748). The composite outcome of thromboembolic events and death was also significantly different, being lower in obese females (P = 0.035). Among male patients, bleeding events were significantly more frequent in obese subjects (P = 0.035). On multivariable Cox analysis, BMI was not independently associated with all-cause mortality. CONCLUSIONS: Among AFpatients, overweight and obesity are common and associated with better outcomes in females (a finding previously reported as "obesity paradox"), while no significant differences in outcomes are detected among male patients. Final multivariable model found that increasing BMI was not associated with increased risk of all-cause death; conversely, age and comorbidities persisted as major determinants.
Authors: Jens Cosedis Nielsen; Yenn-Jiang Lin; Marcio Jansen de Oliveira Figueiredo; Alireza Sepehri Shamloo; Alberto Alfie; Serge Boveda; Nikolaos Dagres; Dario Di Toro; Lee L Eckhardt; Kenneth Ellenbogen; Carina Hardy; Takanori Ikeda; Aparna Jaswal; Elizabeth Kaufman; Andrew Krahn; Kengo Kusano; Valentina Kutyifa; Han S Lim; Gregory Y H Lip; Santiago Nava-Townsend; Hui-Nam Pak; Gerardo Rodríguez Diez; William Sauer; Anil Saxena; Jesper Hastrup Svendsen; Diego Vanegas; Marmar Vaseghi; Arthur Wilde; T Jared Bunch; Alfred E Buxton; Gonzalo Calvimontes; Tze-Fan Chao; Lars Eckardt; Heidi Estner; Anne M Gillis; Rodrigo Isa; Josef Kautzner; Philippe Maury; Joshua D Moss; Gi-Byung Nam; Brian Olshansky; Luis Fernando Pava Molano; Mauricio Pimentel; Mukund Prabhu; Wendy S Tzou; Philipp Sommer; Janice Swampillai; Alejandro Vidal; Thomas Deneke; Gerhard Hindricks; Christophe Leclercq Journal: Europace Date: 2020-08-01 Impact factor: 5.214
Authors: Vicente Bertomeu-Gonzalez; José Moreno-Arribas; María Asunción Esteve-Pastor; Inmaculada Roldán-Rabadán; Javier Muñiz; Paula Raña-Míguez; Martín Ruiz-Ortiz; Ángel Cequier; Vicente Bertomeu-Martínez; Lina Badimón; Manuel Anguita; Gregory Y H Lip; Francisco Marín Journal: J Am Heart Assoc Date: 2019-12-24 Impact factor: 5.501