TY - JOUR
T1 - Overweight and obesity in patients with atrial fibrillation
T2 - Sex differences in 1-year outcomes in the EORP-AF General Pilot Registry
AU - Boriani, Giuseppe
AU - Laroche, Cécile
AU - Diemberger, Igor
AU - Fantecchi, Elisa
AU - Meeder, Joan
AU - Kurpesa, Malgorzata
AU - Baluta, Monica Mariana
AU - Proietti, Marco
AU - Tavazzi, Luigi
AU - Maggioni, Aldo P
AU - Lip, Gregory Y H
AU - EORP-AF General Pilot Registry Investigators
N1 - © 2018 Wiley Periodicals, Inc.
PY - 2018/4
Y1 - 2018/4
N2 - 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, 1084(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. This article is protected by copyright. All rights reserved.
AB - 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, 1084(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. This article is protected by copyright. All rights reserved.
KW - Journal Article
KW - atrial fibrillation
KW - gender
KW - overweight
KW - stroke
KW - EORP-AF registry
KW - obesity
KW - outcome
UR - http://www.scopus.com/inward/record.url?scp=85045350610&partnerID=8YFLogxK
U2 - 10.1111/jce.13428
DO - 10.1111/jce.13428
M3 - Journal article
C2 - 29345382
SN - 1045-3873
VL - 29
SP - 566
EP - 572
JO - Journal of Cardiovascular Electrophysiology
JF - Journal of Cardiovascular Electrophysiology
IS - 4
ER -