Key result
Overweight independently increased the risk of ischemic stroke by 82% (HR 1.82) compared to normal weight in Chinese patients with nonvalvular atrial fibrillation.
Why the study?
Does abnormal body mass index increase the risk of ischemic stroke, thromboembolism, and mortality in Chinese patients with nonvalvular atrial fibrillation?
Observational (n=1,286)
No
Does abnormal body mass index increase the risk of ischemic stroke, thromboembolism, and mortality in Chinese patients with nonvalvular atrial fibrillation?
In Chinese patients with nonvalvular atrial fibrillation, overweight and obesity are independent risk factors for ischemic stroke and thromboembolism, while being underweight is associated with increased all-cause mortality.
Highlights need for weight-focused risk assessment in Chinese NVAF; extends BMI-stroke associations to this group while leaving causality open.
BACKGROUND: Obesity is considered to be related to recurrence of atrial fibrillation (AF), left atrial thrombus formation, and atrial remodeling. However, whether obesity is an independent risk factor for stroke and other thromboembolic events is still controversial. OBJECTIVE: This study aimed to investigate the effects of body mass index (BMI) on the risks of stroke, thromboembolism, and mortality in AF patients. METHODS: Patients who were diagnosed with nonvalvular AF were included in this observational, retrospective study. The study population was stratified by BMI at baseline. The Cox proportional hazard model was adopted to calculate adjusted hazard ratios of risk factors for adverse clinical events (stroke, thromboembolism, and mortality). RESULTS: A total of 1286 AF patients (males, 78.30%; mean age, 74.50 years; 94.48% paroxysmal AF) were followed up for a median of 2.1 years (IQR: 1.5-2.9 years). Overall, 159 patients died. A total of 84 strokes and 35 thromboembolic events occurred. Multivariate analysis showed that overweight (25.0≤BMI<30.0 kg/m2) and age ≥75 years were independent risk factors for ischemic stroke (both P<0.01). Obesity (BMI ≥30.0 kg/m2), age ≥75 years, persistent/permanent AF, and prior thromboembolism were independent risk factors for thromboembolism (all P<0.05). Underweight (BMI <18.5 kg/m2), age ≥75 years, prior ischemic stroke/transient ischemic attack, renal dysfunction, and heart failure were independent risk factors for all-cause deaths (all P<0.05). CONCLUSIONS: Overweight or obesity may be a risk factor of ischemic stroke and thromboembolism in AF patients. Excessive low weight is significantly associated with increased all-cause mortality.
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Wang et al. (2015) conducted an observational in Nonvalvular atrial fibrillation (n=1,286). Overweight (BMI 25.0-29.9 kg/m2) vs. Normal weight (BMI 18.5-24.9 kg/m2) was evaluated on Ischemic stroke (HR 1.82, 95% CI 1.16-2.84, p=0.009). Overweight independently increased the risk of ischemic stroke by 82% (HR 1.82) compared to normal weight in Chinese patients with nonvalvular atrial fibrillation.
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