Clinical research studyInfluence of Obesity on Outcomes in Atrial Fibrillation: Yet Another Obesity Paradox
Section snippets
Methods
We performed a post hoc analysis of the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Trial. A public-use limited-access dataset that was devoid of all patient identifiers was obtained from the National Heart, Lung and Blood Institute (NHLBI). None of the authors are affiliated with the NHLBI or were part of the AFFIRM trial. Appropriate Institutional Review Board approval was obtained from Wayne State University.
Details of the AFFIRM study have been described
Results
There were 637 patients with normal BMI, 965 in the overweight category, and 890 in the obese group. Baseline characteristics of patients in each group are shown in Table 1. Mean age for the entire study population was 69.5 ± 8 years, and 60.71% of the population were males; 16.57% had history of myocardial infarction and 21.31% had history of congestive heart failure. Mean BMI was 29.02 ± 5.9 kg/m2. A total of 304 deaths and 148 cardiovascular deaths occurred over the approximately 3-year/patient
Discussion
In our study, almost three fourths of all atrial fibrillation patients were obese or overweight. We report for the first time a beneficial effect of increasing BMI on outcomes in atrial fibrillation. Because the AFFIRM trial population is considered to be a reasonable representation of the general atrial fibrillation population, our study has significant implications. Similar “obesity paradoxes” have been observed among the elderly and for disorders such as acquired immune deficiency syndrome,
Acknowledgment
The authors would like to thank the National Heart, Lung and Blood Institute (NHLBI), Mr. Sean Coady (NHLBI), and Mr. Kevin Purkiser (NHLBI) for all their help and input.
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Funding: None.
Conflict of Interest: None of the authors have any financial disclosure or conflict of interest to report. None of the study authors are associated with the National Heart, Lung and Blood Institute or the Atrial Fibrillation Follow-up Investigation of Rhythm Management trial.
Authorship: All authors had access to the data and were involved in the conception, data analysis, and writing of the manuscript.