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Pandey A, Gersh BJ, McGuire DK, et al. Association of Body Mass Index With Care and Outcomes in Patients With Atrial Fibrillation: Results From the ORBIT-AF Registry. JACC Clin Electrophysiol. 2015;2(3):355-363doi: 10.1016/j.jacep.2015.12.001.
Pandey, A., Gersh, B. J., McGuire, D. K., Shrader, P., Thomas, L., Kowey, P. R., Mahaffey, K. W., Hylek, E., Sun, S., Burton, P., Piccini, J., Peterson, E., & Fonarow, G. C. (2016). Association of Body Mass Index With Care and Outcomes in Patients With Atrial Fibrillation: Results From the ORBIT-AF Registry. JACC. Clinical electrophysiology, 2(3), 355-363. https://doi.org/10.1016/j.jacep.2015.12.001
Pandey, Ambarish, et al. "Association of Body Mass Index With Care and Outcomes in Patients With Atrial Fibrillation: Results From the ORBIT-AF Registry." JACC. Clinical electrophysiology vol. 2,3 (2016): 355-363. doi: https://doi.org/10.1016/j.jacep.2015.12.001
Pandey A, Gersh BJ, McGuire DK, Shrader P, Thomas L, Kowey PR, Mahaffey KW, Hylek E, Sun S, Burton P, Piccini J, Peterson E, Fonarow GC. Association of Body Mass Index With Care and Outcomes in Patients With Atrial Fibrillation: Results From the ORBIT-AF Registry. JACC Clin Electrophysiol. 2016 Jun;2(3):355-363. doi: 10.1016/j.jacep.2015.12.001. Epub 2015 Dec 09. PMID: 29766895.
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JACC Clin Electrophysiol. 2016 Jun;2(3):355-363. doi: 10.1016/j.jacep.2015.12.001. Epub 2015 Dec 09.

Association of Body Mass Index With Care and Outcomes in Patients With Atrial Fibrillation: Results From the ORBIT-AF Registry.

JACC. Clinical electrophysiology

Ambarish Pandey, Bernard J Gersh, Darren K McGuire, Peter Shrader, Laine Thomas, Peter R Kowey, Kenneth W Mahaffey, Elaine Hylek, Shining Sun, Paul Burton, Jonathan Piccini, Eric Peterson, Gregg C Fonarow

Affiliations

  1. Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
  2. Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  3. Division of Cardiology, Duke Clinical Research Institute, Durham, North Carolina, USA.
  4. Lankenau Institute for Medical Research, Wynnewood, Pennsylvania, USA.
  5. Stanford University School of Medicine, Palo Alto, California, USA.
  6. Boston University School of Medicine, Boston, Massachusetts, USA.
  7. Janssen Scientific Affairs, Raritan, New Jersey, USA.
  8. Division of Cardiology, Ronald Regan-UCLA Medical Center, Los Angeles, California, USA. Electronic address: [email protected].

PMID: 29766895 DOI: 10.1016/j.jacep.2015.12.001

Abstract

OBJECTIVES: This study sought to determine the association between body mass index (BMI) and clinical outcomes among patients with prevalent atrial fibrillation (AF).

BACKGROUND: Higher BMI is an independent risk factor for incident AF. However, its impact on management strategies and clinical outcomes among patients with prevalent AF is unclear.

METHODS: Patients with AF enrolled in the ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry from June 2010 through August 2011 were stratified into BMI-based categories as normal weight, overweight, class I obese, class II obese, and class III obese. Unadjusted and adjusted Cox frailty models were constructed to assess the association of BMI with clinical outcomes over a 2-year follow-up.

RESULTS: We evaluated 9,606 patients with AF (42% women; 78% overweight/obese) from 174 ORBIT participating practices in the United States. Higher BMI patients were younger and had a greater prevalence of diabetes, hypertension, and obstructive sleep apnea (OSA). Use of anticoagulation and rhythm control strategies was significantly greater among higher BMI patients. Rates for all-cause mortality and thromboembolic events decreased in a near linear fashion across increasing BMI categories (p < 0.001). After multivariable adjustment, higher BMI was associated with lower risk for all-cause mortality with lowest risk among class I obese patients (hazard ratio [HR]: 0.65; 95% CI: 0.54 to 0.78); reference: normal weight). For every 5-kg/m

CONCLUSIONS: Although AF patients with higher BMI were significantly younger, higher BMI in AF patients was associated with similar or better clinical outcomes.

Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Keywords: atrial fibrillation; body mass index; mortality; stroke

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