Why the study?
To investigate the relationship between body mass index and clinical outcomes in patients with AF.
Does higher body mass index affect the risk of stroke, death, and bleeding in patients with atrial fibrillation treated with edoxaban or warfarin?
Population
21 028 patients with AF across BMI categories
Comparison
Outcomes across BMI categories and edoxaban vs warfarin
Design
Post-hoc analysis of a randomized trial
Key result
Higher BMI (per 5 kg/m2 increase) was independently associated with a lower risk of stroke or systemic embolic event (HR 0.88, P=0.0001) and death, but an increased risk of major bleeding.
Authors
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Should not yet change anticoagulation practice; hypothesis-generating for BMI in AF risk models.
RCT (n=21,028)
randomized
Does higher body mass index affect the risk of stroke, death, and bleeding in patients with atrial fibrillation treated with edoxaban or warfarin?
Hazard Ratio: 0.88
p-value: p=0.0001
In patients with atrial fibrillation, higher BMI is paradoxically associated with a lower risk of stroke and death but an increased risk of bleeding, while the efficacy and safety of edoxaban remain consistent across BMI categories.
Boriani et al. (2018) conducted an RCT in atrial fibrillation (n=21,028). Higher BMI (per 5 kg/m2 increase) vs. Lower BMI was evaluated on stroke/systemic embolic event (SEE) (HR 0.88, p=0.0001). Higher BMI (per 5 kg/m2 increase) was independently associated with a lower risk of stroke or systemic embolic event (HR 0.88, P=0.0001) and death, but an increased risk of major bleeding.