1. Obesity Paradox and 12 Month Outcome in Patients with Atrial Fibrillation
- Author
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Humberto Álvarez-López, Mario R. Chapela-Villalpando, Julio López-Cuellar, Ambrosio Cruz-Díaz, Ernesto G. Cardona-Muñoz, Abraham Galicia-Reyes, Norberto García-Hernández, Pedro Iturralde-Torres, Luis J. Colín-Lizalde, Yolanda Alfaro-Ledesma, Ismael Hernández-Santamaría, Arturo Abundes-Velasco, Augusto A.O. Flores-Galaviz, Santiago Nava-Townsend, Héctor López-Torres, Celso A. Mendoza-González, César Acevedo-Zepeda, Jorge Carrillo-Calvillo, José R. Azpiri-López, José L. Barrón-Rivera, J. Enrique Martínez-Flores, José L. Leyva-Pons, Eric N. González-Aceves, Maricruz Moreno-Álvarez, Javier F. Antezana-Castro, Marco A. Alcocer-Gamba, Rogelio Robledo-Nolasco, Lecsy Macedo-Calvillo, Fidel Ortiz-Alcalá, José A. Merino-Rajme, Ignacio Rodríguez-Briones, Gerardo Rodríguez-Díez, Manuel R. Barrera-Bustillos, Juan R. Fabregat-Ramírez, Francisco J. González-Martín, Carlos M. Behmaras-Hernández, Guillermo L. Naranjo-Ricoy, Fernando Ortíz-Galván, Erwin Chiquete, Susano Lara-Vaca, Roberto Arriaga-Nava, Juan A. Cordero-Cabra, Luis G. Molina-Fernández-de-Lara, José Antonio Magaña-Serrano, Marco A. Ramos-García, Jorge Cortés-Lawrenz, Carlos L. Fernández-Barros, Felicia Millán-Gómez, Pedro A. Hinojosa-Pineda, Mario A. Benavides-González, Abel A. Pavia-López, Xavier Escudero-Cañedo, José G. Zúñiga-Sedano, Guillermo Ficker-García, Jaqueline M. Rosado-Matos, Arturo Guerra-López, Jesús Siller-Rodríguez, Alejandra Meaney-Martínez, Marco Antonio Ramos-Corrales, Asalea B. López-Cuellar, Humberto Rodríguez-Reyes, Juan C. Ramírez-Ruvalcaba, Francisco J. Guerrero-Martínez, Rosalba Carolina García-Méndez, José L. Zacarías-Martín, Jesús A. González-Hermosillo, Guillermo A. Llamas-Esperón, Juan M. López-Quijano, Francisco J. Martín-de-la-Torre, Jorge A. Moscoso-Maza, Carlos J. Sánchez-Díaz, Ana Ochoa-Guzmán, Gerardo E. Pozas-Garza, Joaquín Vargas-Peñafiel, Gabriela Borrayo-Sánchez, José B. Álvarez-Mosquera, Juan Carlos Perez-Alva, Felipe J. González-Camid, Fernando A. Reyes-Cisneros, José A. Jiménez-Serrano, Francisco J. Robles-Torres, and José M. Portos-Silva
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,Waist ,Time Factors ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Case fatality rate ,Atrial Fibrillation ,Medicine ,Humans ,Mass index ,Longitudinal Studies ,Obesity ,Aged ,business.industry ,Atrial fibrillation ,General Medicine ,Middle Aged ,medicine.disease ,030104 developmental biology ,030220 oncology & carcinogenesis ,Heart failure ,Cohort ,Female ,business ,Obesity paradox ,Kidney disease - Abstract
Background and aim Obesity increases the risk of atrial fibrillation (AF) while it may impact the outcome of patients with AF. The clinical implications of this relationship are not completely clear. We aimed to analyze the association of traditional anthropometric measures of excessive adiposity with 12 month case fatality rate (CFR) in patients with AF. Methods This was a multicenter, longitudinal, observational study on adults with documented AF, excluding records of AF secondary to reversible causes. Anthropometric variables were registered at baseline, and a central committee validated the 12 month outcomes. Results We studied 1193 patients (median age: 69.14 years, 55.2% women). At baseline, rhythm control was established for 476 (39.9%) subjects, while frequency control was offered to 717 (60.1%) participants. The 12 month all-cause CFR was 8.9%. A high basal body mass index (BMI), waist-to-height ratio (WHtR) and waist circumference (WC) were associated with lower CFR in bivariate analyses. In a Cox-proportional hazards model, variables associated with 12 month all-cause CFR were BMI categories (HR: 0.736, 95% CI: 0.584–0.928), chronic heart failure (HR: 1.738, 95% CI: 1.127–2.680), chronic kidney disease (HR: 2.269, 95% CI: 1.162–4.429) and carotid stenosis >50% (HR: 5.342, 95% CI: 1.661–17.181). Conclusion The risk of death at one year in patients with AF is inversely associated with a high BMI and directly associated with the presence of chronic kidney disease, carotid stenosis, and chronic heart failure in this cohort of patients with AF. The causes and implications of this apparent obesity paradox should be addressed in the future.
- Published
- 2020