Key result
Overweight and obesity linked to ~48% lower 1-year mortality vs normal BMI in women with AF.
Why the study?
Does overweight and obesity impact 1-year mortality and cardiovascular outcomes differently in male and female patients with atrial fibrillation?
Observational (n=2,540)
Yes
Does overweight and obesity impact 1-year mortality and cardiovascular outcomes differently in male and female patients with atrial fibrillation?
Absolute Event Rate: 4.3% vs 9.3%
p-value: p=0.023
While an 'obesity paradox' for 1-year mortality was observed in female but not male patients with atrial fibrillation, multivariable analysis revealed that age and comorbidities, rather than BMI, are the major determinants of mortality.
May support sex-specific obesity paradox in female AF; leaves open whether age and comorbidities, not BMI, drive mortality.
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: ), 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, 1,084 (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.
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Boriani et al. (2018) conducted an observational in Atrial fibrillation (n=2,540). Overweight and obesity vs. Normal BMI was evaluated on All-cause mortality in female patients (p=0.023). Among female patients with atrial fibrillation, overweight and obesity were associated with lower 1-year all-cause mortality compared to normal BMI (4.3% and 5.3% vs 9.3%, P=0.023).
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