Results — An obesity paradox was found for cardiovascular death and all-cause death in the subgroup analyses of r and omized trial cohorts ; however , observational studies fail to show this relationship .
Conclusions — There may be an obesity paradox in atrial fibrillation patients , particularly for all-cause and cardiovascular death outcomes .
An obesity paradox was also evident for stroke/systemic embolic event outcome in NOAC trials , with a treatment effect favoring NOACs over warfarin for both efficacy and safety that was significant only for normal weight patients
Background and Purpose — Obesity is a risk factor for all-cause and cardiovascular death but , despite this , an inverse relationship between overweight or obesity and a better cardiovascular prognosis in long-term follow-up studies has been observed ; this phenomenon , described as obesity paradox , has also been found evident in atrial fibrillation cohorts .
Methods — We performed a systematic review on the relationship between body mass index and major adverse outcomes in atrial fibrillation patients .
Body mass index and adverse events in patients with incident atrial fibrillation.
BACKGROUND Obesity is associated with the development of atrial fibrillation and may impact atrial fibrillation-related outcomes . To date , no anthropometric measure is included in any risk stratification scheme for stroke and death in atrial fibrillation patients . METHODS The prospect i ve Danish Diet , Cancer and Health study is a cohort including 57,053 participants ( 27,178 men and 29,875 women ) aged between 50 and 64 years . The study population for this study included the 3135 patients ( 2025 men and 1110 women ) who developed incident atrial fibrillation during follow-up . RESULTS Of the subjects with atrial fibrillation , 1414 ( 45 % ) had a body mass index ( BMI ) in the overweight category ( BMI 25 to < 30 kg/m(2 ) ) and 767 ( 24 % ) were categorized as obese ( BMI ≥30 kg/m(2 ) ) . During a median follow-up of 4.9 years , 609 deaths and 216 thromboembolic events ( 98 % ischemic strokes ) occurred . Using normal-weight patients as reference , the risk of a composite end point of " ischemic stroke , thromboembolism , or death " was significantly higher in overweight ( crude hazard ratio [ HR ] 1.31 ; 95 % confidence interval [ CI ] , 1.09 - 1.56 ) and obese patients ( crude HR 1.55 ; 95 % CI 1.27 - 1.90 ) . After adjustment for CHADS2 and CHA2DS2-VASc scores , the HRs for the composite end point were 1.21 ( 95 % CI 1.02 - 1.45 ) and 1.31 ( 95 % CI 1.10 - 1.56 ) , respectively , for overweight and 1.25 ( 95 % CI 1.03 - 1.53 ) and 1.36 ( 95 % CI 1.11 - 1.65 ) , respectively , for obese . Continuous analyses of BMI stratified by sex identified obese men and normal-weight women as the sex-specific " high-risk " categories . CONCLUSION Overweight and obesity are risk factors for " ischemic stroke , thromboembolism or death " in patients with atrial fibrillation , even after adjustment for CHADS2 and CHA2DS2-VASc scores . The association between BMI and outcomes among atrial fibrillation patients may be modified by sex
Results — An obesity paradox was found for cardiovascular death and all-cause death in the subgroup analyses of r and omized trial cohorts ; however , observational studies fail to show this relationship .
Conclusions — There may be an obesity paradox in atrial fibrillation patients , particularly for all-cause and cardiovascular death outcomes .
An obesity paradox was also evident for stroke/systemic embolic event outcome in NOAC trials , with a treatment effect favoring NOACs over warfarin for both efficacy and safety that was significant only for normal weight patients
Background and Purpose — Obesity is a risk factor for all-cause and cardiovascular death but , despite this , an inverse relationship between overweight or obesity and a better cardiovascular prognosis in long-term follow-up studies has been observed ; this phenomenon , described as obesity paradox , has also been found evident in atrial fibrillation cohorts .
Methods — We performed a systematic review on the relationship between body mass index and major adverse outcomes in atrial fibrillation patients .