Association of body mass index with outcomes in patients with newly diagnosed atrial fibrillation: GARFIELD-AF
Issued Date
2022-08-01
Resource Type
ISSN
2398595X
eISSN
20533624
Scopus ID
2-s2.0-85135986968
Journal Title
Open Heart
Volume
9
Issue
2
Rights Holder(s)
SCOPUS
Bibliographic Citation
Open Heart Vol.9 No.2 (2022)
Suggested Citation
Camm C.F., Virdone S., Goto S., Bassand J.P., Van Eickels M., Haas S., Gersh B.J., Pieper K., Fox K.A.A., Misselwitz F., Turpie A.G.G., Goldhaber S.Z., Verheugt F., Camm J., Kayani G., Panchenko E., Oh S., Luciardi H.L., Sawhney J.P.S., Connolly S.J., Angchaisuksiri P., Ten Cate H., Eikelboom J.W., Kakkar A.K. Association of body mass index with outcomes in patients with newly diagnosed atrial fibrillation: GARFIELD-AF. Open Heart Vol.9 No.2 (2022). doi:10.1136/openhrt-2022-002038 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/85657
Title
Association of body mass index with outcomes in patients with newly diagnosed atrial fibrillation: GARFIELD-AF
Author's Affiliation
University of Oxford, Keble College
CARIM School for Cardiovascular Disease
Ministry of Health of Russian Federation
McMaster University
Université de Franche-Comté
St George’s, University of London
Tokai University School of Medicine
The University of Edinburgh
Royal Berkshire NHS Foundation Trust
OLVG
University College London
Seoul National University Hospital
Technische Universität München
Universiteit Maastricht
Brigham and Women's Hospital
Thrombosis Research Institute
Mahidol University
Bayer AG
Mayo Clinic
Universidad Nacional de Tucuman (UNT)
Royal Infirmary of Edinburgh
Sir Ganga Ram Hospital
CARIM School for Cardiovascular Disease
Ministry of Health of Russian Federation
McMaster University
Université de Franche-Comté
St George’s, University of London
Tokai University School of Medicine
The University of Edinburgh
Royal Berkshire NHS Foundation Trust
OLVG
University College London
Seoul National University Hospital
Technische Universität München
Universiteit Maastricht
Brigham and Women's Hospital
Thrombosis Research Institute
Mahidol University
Bayer AG
Mayo Clinic
Universidad Nacional de Tucuman (UNT)
Royal Infirmary of Edinburgh
Sir Ganga Ram Hospital
Other Contributor(s)
Abstract
Objective While greater body mass index (BMI) is associated with increased risk of developing atrial fibrillation (AF), the impact of BMI on outcomes in newly diagnosed AF is unclear. We examine the influence of BMI on outcomes and whether this is modified by sex and evaluate the effect of non-vitamin K oral anticoagulants (NOACs) in patients with high BMI. Methods GARFIELD-AF is a prospective registry of 52 057 newly diagnosed AF patients. The study population comprised 40 482 participants: 703 underweight (BMI <18.5 kg/m 2), 13 095 normal (BMI=18.5-24.9 kg/m 2), 15 043 overweight (BMI=25.0-29.9 kg/m 2), 7560 obese (BMI=30.0-34.9 kg/m 2) and 4081 extremely obese (BMI ≥35.0 kg/m 2). Restricted cubic splines quantified the association of BMI with outcomes. Comparative effectiveness of NOACs and vitamin K antagonists (VKAs) by BMI was performed using propensity score overlap-weighted Cox models. Results The median age of participants was 71.0 years (Q1; Q3 62.0; 78.0), and 55.6% were male. Those with high BMI were younger, more often had vascular disease, hypertension and diabetes. Within 2-year follow-up, a U-shaped relationship between BMI and all-cause mortality was observed, with BMI of ∼30 kg/m 2 associated with the lowest risk. The association with new/worsening heart failure was similar. Only low BMI was associated with major bleeding and no association emerged for non-haemorrhagic stroke. BMI was similarly associated with outcomes in men and women. BMI did not impact the lower rate of all-cause mortality of NOACs compared with VKAs. Conclusions In the GARFIELD-AF registry, underweight and extremely obese AF patients have increased risk of mortality and new/worsening heart failure compared with normal or obese patients.