BMI and Long-Term Non-Valvular Atrial Fibrillation Outcomes

By Patrick Daly - Last Updated: November 4, 2022

In a recent study, researchers explored associations between body mass index (BMI) and long-term clinical outcomes in patient’s with non-valvular atrial fibrillation (NVAF) taking oral anticoagulants (OAC) using registry data. According to the authors, patients who were underweight had greater risk for all-cause mortality and ischemic events compared with other patients. The findings were published in Heart and Vessels.

Lower BMI Increases Mortality and Ischemic Risk in NVAF

The study included 6927 outpatients with NVAF taking vitamin K antagonists (VKAs) from 71 medical centers in Japan. The report noted that physicians in charge could swap participants from VKAs to direct OACs during follow-up. Patients were categorized as underweight (BMI < 18.5), normal weight (18.5 ≤ BMI < 25), overweight (25 ≤ BMI < 30), or obese (30 ≤ BMI), and Cox proportional hazards models were used to examine differences between normal weight and the other BMI groups.

Over a median follow-up of 3.9 years, patients in the underweight group had significantly increased risk for all-cause death (adjusted hazard ratio [HR], 1.75; 95% CI, 1.30-2.34), as well as ischemic events (HR, 1.61; 95% CI, 1.04-2.50) compared with patients in the normal weight group. Conversely, patients in the overweight group had a reduced risk of all-cause death compared with normal weight patients (HR, 0.63; 95% CI, 0.49-0.82).

The authors added that an additional restricted cubic spline regression model adjusted by multivariate Cox hazard models confirmed that patients in the lower BMI range had significantly higher risks for all-cause death and ischemic events.

In short,”among NVAF patients taking OACs, underweight patients had higher risks of all-cause death and ischemic events than other patients. Overweight patients had lower risk of all-cause death,” the authors summarized.

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