P3569Impact of body mass index in newly diagnosed atrial fibrillation in the GARFIELD-AF registry

Purpose: To analyze the association of body mass index (BMI) with comorbidities and outcomes of patients with newly diagnosed atrial fibrillation (AF) and ≥1 stroke risk factor. Methods: 28,628 patients were enrolled from Mar 2010 to Oct 2014 in the prospective GARFIELD-AF registry. BMI data were available for 22,541 patients, stratified as: underweight (3.2%), normal (25.3%), overweight (40.2%), obese (20.1%), and morbidly obese (11.1%). Results: Increasing BMI was associated with younger age and higher rates of hypertension, hypercholesterolemia, type 2 diabetes, coronary artery disease, and CHF. Underweight patients had the highest prevalence of prior stroke/TIA, bleeding, and moderate-to-severe CKD (Table). The proportion of patients with NYHA class III/IV CHF was similar in both morbidly obese and underweight patients. Obese (vs underweight) patients were more likely to receive oral anticoagulants (67.2% vs 53.2%). Crude 2-yr all-cause mortality per 100 person-years (95% CI) was 8.71 (7.20, 10.53) in underweight, 4.50 (4.10, 4.93) normal, 3.13 (2.77, 3.53) obese, and 2.88 (2.35, 3.53) in the morbidly obese (BMI 35-<40 kg/m2). The poorer outcomes in underweight patients persisted after adjustment for baseline factors (figure). Half of deaths in the underweight vs 36.2% in patients with BMI ≥40 kg/m2 were due to non-cardiovascular events.