Association of body mass index with outcomes in patients with newly diagnosed atrial fibrillation: GARFIELD-AF
Why the study?
While greater body mass index is associated with an increased risk of developing AF, the impact of BMI on outcomes in newly diagnosed AF was unclear.
Does BMI affect outcomes in newly diagnosed atrial fibrillation and modify the comparative effectiveness of NOACs versus VKAs?
Population
40 482 patients with newly diagnosed AF
Comparison
Underweight, overweight, obese, and extremely obese vs normal BMI, and NOACs vs VKAs
Design
Prospective registry analysis
Follow-up
2-year
Authors
Discussion
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Member takes
Implication
Supports obesity paradox in new AF; leaves open whether BMI modifies NOAC benefit over VKAs.
Structured PICO
Does BMI affect outcomes in newly diagnosed atrial fibrillation and modify the comparative effectiveness of NOACs versus VKAs?
P
Population
40,482 patients with newly diagnosed atrial fibrillation from the prospective GARFIELD-AF registry, median age 71.0, 55.6% male.
I
Intervention
Body Mass Index (BMI) categories (underweight, normal, overweight, obese, extremely obese) and non-vitamin K oral anticoagulants (NOACs)
C
Comparator
Normal BMI (18.5-24.9 kg/m2) and vitamin K antagonists (VKAs)
O
Outcome
All-cause mortality within 2-year follow-uphard clinical
In newly diagnosed AF, there is an obesity paradox where a BMI of ~30 kg/m2 is associated with the lowest mortality, and BMI does not alter the mortality benefit of NOACs over VKAs.
Cite This Study
Camm et al. (2022) studied this question.