Impact of anthropometric factors on outcomes in atrial fibrillation patients: analysis on 10 220 patients from the European Society of Cardiology (ESC)-European Heart Rhythm Association (EHRA) EurObservational Research Programme on Atrial Fibrillation (EORP-AF) general long-term registry
Authors: Boriani Giuseppe , Vitolo Marco , Malavasi Vincenzo L , Proietti Marco , Fantecchi Elisa , Diemberger Igor , Fauchier Laurent , Marin Francisco , Nabauer Michael , Potpara Tatjana S , Dan Gheorghe-Andrei , Kalarus Zbigniew , Tavazzi Luigi , Maggioni Aldo Pietro , Lane Deirdre A , Lip Gregory Y H ,   ESC-EHRA EORP-AF Long-Term General Registry Investigators, Boriani G , Lip G Y H , Tavazzi L , Maggioni A P , Dan G-A , Potpara T , Nabauer M , Marin F , Kalarus Z , Fauchier L , Goda A , Mairesse G , Shalganov T , Antoniades L , Taborsky M , Riahi S , Muda P , García Bolao I , Piot O , Nabauer M , Etsadashvili K , Simantirakis EN , Haim M , Azhari A , Santini M , Mirrakhimov E , Kulzida K , Erglis A , Poposka L , Burg MR , Crijns H , Atar D , Lenarczyk R , Martins Oliveira M , Shah D , Dan G-A , Serdechnaya E , Potpara T , Diker E , Lip G Y H , Lane D , Zëra E , Ekmekçiu U , Paparisto V , Tase M , Gjergo H , Dragoti J , Goda A , Ciutea M , Ahadi N , el Husseini Z , Raepers M , Leroy J , Haushan P , Jourdan A , Lepiece C , Desteghe L , Vijgen J , Koopman P , Van Genechten G , Heidbuchel H , Boussy T , De Coninck M , Van Eeckhoutte H , Bouckaert N , Friart A , Boreux J , Arend C , Evrard P , Stefan L , Hoffer E , Herzet J , Massoz M , Celentano C , Sprynger M , Pierard L , Melon P , Van Hauwaert B , Kuppens C , Faes D , Van Lier D , Van Dorpe A , Gerardy A , Deceuninck O , Xhaet O , Dormal F , Ballant E , Blommaert D , Yakova D , Hristov M , Yncheva T , Stancheva N , Tisheva S , Tokmakova M , Nikolov F , Gencheva D , Shalganov T , Kunev B , Stoyanov M , Marchov D , Gelev V , Traykov V , Kisheva A , Tsvyatkov H , Shtereva R , Bakalska-Georgieva S , Slavcheva S , Yotov Y , Kubíčková M , Marni Joensen A , Gammelmark A , Hvilsted Rasmussen L , Dinesen P , Riahi S , Krogh Venø S , Sorensen B , Korsgaard A , Andersen K , Fragtrup Hellum C , Svenningsen A , Nyvad O , Wiggers P , May O , Aarup A , Graversen B , Jensen L , Andersen M , Svejgaard M , Vester S , Hansen S , Lynggaard V , Ciudad M , Vettus R , Muda P , Maestre A , Castaño S , Cheggour S , Poulard J , Mouquet V , Leparrée S , Bouet J , Taieb J , Doucy A , Duquenne H , Furber A , Dupuis J , Rautureau J , Font M , Damiano P , Lacrimini M , Abalea J , Boismal S , Menez T , Mansourati J , Range G , Gorka H , Laure C , Vassalière C , Elbaz N , Lellouche N , Djouadi K , Roubille F , Dietz D , Davy J , Granier M , Winum P , Leperchois-Jacquey C , Kassim H , Marijon E , Le Heuzey J , Fedida J , Maupain C , Himbert C , Gandjbakhch E , Hidden-Lucet F , Duthoit G , Badenco N , Chastre T , Waintraub X , Oudihat M , Lacoste J , Stephan C , Bader H , Delarche N , Giry L , Arnaud D , Lopez C , Boury F , Brunello I , Lefèvre M , Mingam R , Haissaguerre M , Le Bidan M , Pavin D , Le Moal V , Leclercq C , Piot O , Beitar T , Martel I , Schmid A , Sadki N , Romeyer-Bouchard C , Da Costa A , Arnault I , Boyer M , Piat C , Fauchier L , Lozance N , Nastevska S , Doneva A , Fortomaroska Milevska B , Sheshoski B , Petroska K , Taneska N , Bakrecheski N , Lazarovska K , Jovevska S , Ristovski V , Antovski A , Lazarova E , Kotlar I , Taleski J , Poposka L , Kedev S , Zlatanovik N , Jordanova S , Bajraktarova Proseva T , Doncovska S , Maisuradze D , Esakia A , Sagirashvili E , Lartsuliani K , Natelashvili N , Gumberidze N , Gvenetadze R , Etsadashvili K , Gotonelia N , Kuridze N , Papiashvili G , Menabde I , Glöggler S , Napp A , Lebherz C , Romero H , Schmitz K , Berger M , Zink M , Köster S , Sachse J , Vonderhagen E , Soiron G , Mischke K , Reith R , Schneider M , Rieker W , Boscher D , Taschareck A , Beer A , Oster D , Ritter O , Adamczewski J , Walter S , Frommhold A , Luckner E , Richter J , Schellner M , Landgraf S , Bartholome S , Naumann R , Schoeler J , Westermeier D , William F , Wilhelm K , Maerkl M , Oekinghaus R , Denart M , Kriete M , Tebbe U , Scheibner T , Gruber M , Gerlach A , Beckendorf C , Anneken L , Arnold M , Lengerer S , Bal Z , Uecker C , Förtsch H , Fechner S , Mages V , Martens E , Methe H , Schmidt T , Schaeffer B , Hoffmann B , Moser J , Heitmann K , Willems S , Willems S , Klaus C , Lange I , Durak M , Esen E , Mibach F , Mibach H , Utech A , Gabelmann M , Stumm R , Ländle V , Gartner C , Goerg C , Kaul N , Messer S , Burkhardt D , Sander C , Orthen R , Kaes S , Baumer A , Dodos F , Barth A , Schaeffer G , Gaertner J , Winkler J , Fahrig A , Aring J , Wenzel I , Steiner S , Kliesch A , Kratz E , Winter K , Schneider P , Haag A , Mutscher I , Bosch R , Taggeselle J , Meixner S , Schnabel A , Shamalla A , Hötz H , Korinth A , Rheinert C , Mehltretter G , Schön B , Schön N , Starflinger A , Englmann E , Baytok G , Laschinger T , Ritscher G , Gerth A , Dechering D , Eckardt L , Kuhlmann M , Proskynitopoulos N , Brunn J , Foth K , Axthelm C , Hohensee H , Eberhard K , Turbanisch S , Hassler N , Koestler A , Stenzel G , Kschiwan D , Schwefer M , Neiner S , Hettwer S , Haeussler-Schuchardt M , Degenhardt R , Sennhenn S , Steiner S , Brendel M , Stoehr A , Widjaja W , Loehndorf S , Logemann A , Hoskamp J , Grundt J , Block M , Ulrych R , Reithmeier A , Panagopoulos V , Martignani C , Bernucci D , Fantecchi E , Diemberger I , Ziacchi M , Biffi M , Cimaglia P , Frisoni J , Boriani G , Giannini I , Boni S , Fumagalli S , Pupo S , Di Chiara A , Mirone P , Fantecchi E , Boriani G , Pesce F , Zoccali C , Malavasi V L , Mussagaliyeva A , Ahyt B , Salihova Z , Koshum-Bayeva K , Kerimkulova A , Bairamukova A , Mirrakhimov E , Lurina B , Zuzans R , Jegere S , Mintale I , Kupics K , Jubele K , Erglis A , Kalejs O , Vanhear K , Burg M , Cachia M , Abela E , Warwicker S , Tabone T , Xuereb R , Asanovic D , Drakalovic D , Vukmirovic M , Pavlovic N , Music L , Bulatovic N , Boskovic A , Uiterwaal H , Bijsterveld N , De Groot J , Neefs J , van den Berg N , Piersma F , Wilde A , Hagens V , Van Es J , Van Opstal J , Van Rennes B , Verheij H , Breukers W , Tjeerdsma G , Nijmeijer R , Wegink D , Binnema R , Said S , Erküner Ö , Philippens S , van Doorn W , Crijns H , Szili-Torok T , Bhagwandien R , Janse P , Muskens A , van Eck M , Gevers R , van der Ven N , Duygun A , Rahel B , Meeder J , Vold A , Holst Hansen C , Engset I , Atar D , Dyduch-Fejklowicz B , Koba E , Cichocka M , Sokal A , Kubicius A , Pruchniewicz E , Kowalik-Sztylc A , Czapla W , Mróz I , Kozlowski M , Pawlowski T , Tendera M , Winiarska-Filipek A , Fidyk A , Slowikowski A , Haberka M , Lachor-Broda M , Biedron M , Gasior Z , Kołodziej M , Janion M , Gorczyca-Michta I , Wozakowska-Kaplon B , Stasiak M , Jakubowski P , Ciurus T , Drozdz J , Simiera M , Zajac P , Wcislo T , Zycinski P , Kasprzak J , Olejnik A , Harc-Dyl E , Miarka J , Pasieka M , Ziemińska-Łuć M , Bujak W , Śliwiński A , Grech A , Morka J , Petrykowska K , Prasał M , Hordyński G , Feusette P , Lipski P , Wester A , Streb W , Romanek J , Woźniak P , Chlebuś M , Szafarz P , Stanik W , Zakrzewski M , Kaźmierczak J , Przybylska A , Skorek E , Błaszczyk H , Stępień M , Szabowski S , Krysiak W , Szymańska M , Karasiński J , Blicharz J , Skura M , Hałas K , Michalczyk L , Orski Z , Krzyżanowski K , Skrobowski A , Zieliński L , Tomaszewska-Kiecana M , Dłużniewski M , Kiliszek M , Peller M , Budnik M , Balsam P , Opolski G , Tymińska A , Ozierański K , Wancerz A , Borowiec A , Majos E , Dabrowski R , Szwed H , Musialik-Lydka A , Leopold-Jadczyk A , Jedrzejczyk-Patej E , Koziel M , Lenarczyk R , Mazurek M , Kalarus Z , Krzemien-Wolska K , Starosta P , Nowalany-Kozielska E , Orzechowska A , Szpot M , Staszel M , Almeida S , Pereira H , Brandão Alves L , Miranda R , Ribeiro L , Costa F , Morgado F , Carmo P , Galvao Santos P , Bernardo R , Adragão P , Ferreira da Silva G , Peres M , Alves M , Leal M , Cordeiro A , Magalhães P , Fontes P , Leão S , Delgado A , Costa A , Marmelo B , Rodrigues B , Moreira D , Santos J , Santos L , Terchet A , Darabantiu D , Mercea S , Turcin Halka V , Pop Moldovan A , Gabor A , Doka B , Catanescu G , Rus H , Oboroceanu L , Bobescu E , Popescu R , Dan A , Buzea A , Daha I , Dan G , Neuhoff I , Baluta M , Ploesteanu R , Dumitrache N , Vintila M , Daraban A , Japie C , Badila E , Tewelde H , Hostiuc M , Frunza S , Tintea E , Bartos D , Ciobanu A , Popescu I , Toma N , Gherghinescu C , Cretu D , Patrascu N , Stoicescu C , Udroiu C , Bicescu G , Vintila V , Vinereanu D , Cinteza M , Rimbas R , Grecu M , Cozma A , Boros F , Ille M , Tica O , Tor R , Corina A , Jeewooth A , Maria B , Georgiana C , Natalia C , Alin D , Dinu-Andrei D , Livia M , Daniela R , Larisa R , Umaar S , Tamara T , Ioachim Popescu M , Nistor D , Sus I , Coborosanu O , Alina-Ramona N , Dan R , Petrescu L , Ionescu G , Popescu I , Vacarescu C , Goanta E , Mangea M , Ionac A , Mornos C , Cozma D , Pescariu S , Solodovnicova E , Soldatova I , Shutova J , Tjuleneva L , Zubova T , Uskov V , Obukhov D , Rusanova G , Soldatova I , Isakova N , Odinsova S , Arhipova T , Kazakevich E , Serdechnaya E , Zavyalova O , Novikova T , Riabaia I , Zhigalov S , Drozdova E , Luchkina I , Monogarova Y , Hegya D , Rodionova L , Rodionova L , Nevzorova V , Soldatova I , Lusanova O , Arandjelovic A , Toncev D , Vukmirovic L , Radisavljevic M , Milanov M , Sekularac N , Zdravkovic M , Hinic S , Dimkovic S , Acimovic T , Saric J , Radovanovic S , Kocijancic A , Obrenovic-Kircanski B , Kalimanovska Ostric D , Simic D , Jovanovic I , Petrovic I , Polovina M , Vukicevic M , Tomasevic M , Mujovic N , Radivojevic N , Petrovic O , Aleksandric S , Kovacevic V , Mijatovic Z , Ivanovic B , Tesic M , Potpara T , Ristic A , Vujisic-Tesic B , Nedeljkovic M , Karadzic A , Uscumlic A , Prodanovic M , Zlatar M , Asanin M , Bisenic B , Vasic V , Popovic Z , Djikic D , Sipic M , Peric V , Dejanovic B , Milosevic N , Backovic S , Stevanovic A , Andric A , Pencic B , Pavlovic-Kleut M , Celic V , Pavlovic M , Petrovic M , Vuleta M , Petrovic N , Simovic S , Savovic Z , Milanov S , Davidovic G , Iric-Cupic V , Djordjevic D , Damjanovic M , Zdravkovic S , Topic V , Stanojevic D , Randjelovic M , Jankovic-Tomasevic R , Atanaskovic V , Antic S , Pavlovic M , Simonovic D , Stojanovic M , Stojanovic S , Mitic V , Ilic V , Petrovic D , Deljanin Ilic M , Ilic S , Stoickov V , Markovic S , Mijatovic A , Tanasic D , Petrovic D , Radakovic G , Peranovic J , Pavlovic M , Panic-Jelic N , Vujadinovic O , Pajic P , Bekic S , Kovacevic S , García Fernandez A , Perez Cabeza A , Anguita M , Tercedor Sanchez L , Mau E , Loayssa J , Ayarra M , Carpintero M , Roldán Rabadan I , Leal M , Gil Ortega M , Tello Montoliu A , Orenes Piñero E , Manzano Fernández S , Marín F , Romero Aniorte A , Veliz Martínez A , Quintana Giner M , Ballesteros G , Palacio M , Alcalde O , García-Bolao I , Bertomeu Gonzalez V , Otero-Raviña F , García Seara J , Gonzalez Juanatey J , Dayal N , Maziarski P , Gentil-Baron P , Shah D , Koç M , Onrat E , Dural I E , Yilmaz K , Özin B , Tan Kurklu S , Atmaca Y , Canpolat U , Tokgozoglu L , Dolu A K , Demirtas B , Sahin D , Ozcan Celebi O , Diker E , Gagirci G , Turk U O , Ari H , Polat N , Toprak N , Sucu M , Akin Serdar O , Taha Alper A , Kepez A , Yuksel Y , Uzunselvi A , Yuksel S , Sahin M , Kayapinar O , Ozcan T , Kaya H , Yilmaz M B , Kutlu M , Demir M , Gibbs C , Kaminskiene S , Bryce M , Skinner A , Belcher G , Hunt J , Stancombe L , Holbrook B , Peters C , Tettersell S , Shantsila A , Lane D , Senoo K , Proietti M , Russell K , Domingos P , Hussain S , Partridge J , Haynes R , Bahadur S , Brown R , McMahon S , Y H Lip G , McDonald J , Balachandran K , Singh R , Garg S , Desai H , Davies K , Goddard W , Galasko G , Rahman I , Chua Y , Payne O , Preston S , Brennan O , Pedley L , Whiteside C , Dickinson C , Brown J , Jones K , Benham L , Brady R , Buchanan L , Ashton A , Crowther H , Fairlamb H , Thornthwaite S , Relph C , McSkeane A , Poultney U , Kelsall N , Rice P , Wilson T , Wrigley M , Kaba R , Patel T , Young E , Law J , Runnett C , Thomas H , McKie H , Fuller J , Pick S , Sharp A , Hunt A , Thorpe K , Hardman C , Cusack E , Adams L , Hough M , Keenan S , Bowring A , Watts J , Zaman J , Goffin K , Nutt H , Beerachee Y , Featherstone J , Mills C , Pearson J , Stephenson L , Grant S , Wilson A , Hawksworth C , Alam I , Robinson M , Ryan S , Egdell R , Gibson E , Holland M , Leonard D , Mishra B , Ahmad S , Randall H , Hill J , Reid L , George M , McKinley S , Brockway L , Milligan W , Sobolewska J , Muir J , Tuckis L , Winstanley L , Jacob P , Kaye S , Morby L , Jan A , Sewell T , Boos C , Wadams B , Cope C , Jefferey P , Andrews N , Getty A , Suttling A , Turner C , Hudson K , Austin R , Howe S , Iqbal R , Gandhi N , Brophy K , Mirza P , Willard E , Collins S , Ndlovu N , Subkovas E , Karthikeyan V , Waggett L , Wood A , Bolger A , Stockport J , Evans L , Harman E , Starling J , Williams L , Saul V , Sinha M , Bell L , Tudgay S , Kemp S , Brown J , Frost L , Ingram T , Loughlin A , Adams C , Adams M , Hurford F , Owen C , Miller C , Donaldson D , Tivenan H , Button H , Nasser A , Jhagra O , Stidolph B , Brown C , Livingstone C , Duffy M , Madgwick P , Roberts P , Greenwood E , Fletcher L , Beveridge M , Earles S , McKenzie D , Beacock D , Dayer M , Seddon M , Greenwell D , Luxton F , Venn F , Mills H , Rewbury J , James K , Roberts K , Tonks L , Felmeden D , Taggu W , Summerhayes A , Hughes D , Sutton J , Felmeden L , Khan M , Walker E , Norris L , O'Donohoe L , Mozid A , Dymond H , Lloyd-Jones H , Saunders G , Simmons D , Coles D , Cotterill D , Beech S , Kidd S , Wrigley B , Petkar S , Smallwood A , Jones R , Radford E , Milgate S , Metherell S , Cottam V , Buckley C , Broadley A , Wood D , Allison J , Rennie K , Balian L , Howard L , Pippard L , Board S , Pitt-Kerby T 
Published: June 2022

Abstract

Aim
To investigate the association of anthropometric parameters [height, weight, body mass index (BMI), body surface area (BSA), and lean body mass (LBM)] with outcomes in atrial fibrillation (AF).

Methods and results
Ten-thousand two-hundred twenty patients were enrolled [40.3% females, median age 70 (62–77) years, followed for 728 (interquartile range 653–745) days]. Sex-specific tertiles were considered for the five anthropometric variables. At the end of follow-up, survival free from all-cause death was worse in the lowest tertiles for all the anthropometric variables analyzed. On multivariable Cox regression analysis, an independent association with all-cause death was found for the lowest vs. middle tertile when body weight (hazard ratio [HR] 1.66, 95%CI 1.23–2.23), BMI (HR 1.65, 95%CI 1.23–2.21), and BSA (HR 1.49, 95%CI 1.11–2.01) were analysed in female sex, as well as for body weight in male patients (HR 1.61, 95%CI 1.25–2.07). Conversely, the risk of MACE was lower for the highest tertile (vs. middle tertile) of BSA and LBM in males and for the highest tertile of weight and BSA in female patients. A higher occurrence of haemorrhagic events was found for female patients in the lowest tertile of height [odds ratio (OR) 1.90, 95%CI 1.23–2.94] and LBM (OR 2.13, 95%CI 1.40–3.26).

Conclusions
In AF patients height, weight, BMI, BSA, and LBM were associated with clinical outcomes, with all-cause death being higher for patients presenting lower values of these variables, i.e. in the lowest tertiles of distribution. The anthropometric variables independently associated with other outcomes were also different between male and female subjects.