Portal de Periódicos da CAPES

Obesity Paradox and 12 Month Outcome in Patients with Atrial Fibrillation

2020; Elsevier BV; Volume: 52; Issue: 2 Linguagem: Inglês

10.1016/j.arcmed.2020.10.015

1873-5487

Humberto Rodríguez-Reyes, Susano Lara-Vaca, Ana Ochoa-Guzmán, Erwin Chiquete, Arturo Abundes-Velasco, César Acevedo-Zepeda, Marco A. Alcocer‐Gamba, Yolanda Alfaro-Ledesma, Humberto Álvarez-López, José B. Álvarez-Mosquera, Javier Antezana-Castro, Roberto Arriaga-Nava, J. R. Azpiri-López, Manuel R. Barrera-Bustillos, José L. Barrón-Rivera, Carlos M. Behmaras-Hernández, Mario Alberto Benavides-González, Gabriela Borrayo–Sánchez, Ernesto Germán Cardona-Muñóz, Jorge Carrillo‐Calvillo, Mario R. Chapela-Villalpando, Luis Colín-Lizalde, Juan A. Cordero-Cabra, Jorge Cortés-Lawrenz, Ambrosio Cruz-Díaz, Xavier Escudero-Cañedo, Juan R. Fabregat-Ramírez, Carlos Fernández-Barros, Guillermo Ficker-García, Augusto A.O. Flores-Galaviz, Abraham Galicia-Reyes, Norberto García-Hernández, Rosalba Carolina García-Méndez, Eric Noel González-Aceves, Felipe J. González-Camid, Jesús Antonio González-Hermosillo, Francisco J. González-Martín, Arturo Guerra-López, Francisco J. Guerrero-Martínez, Ismael Hernández-Santamaría, Pedro A. Hinojosa-Pineda, Pedro Iturralde-Torres, José A. Jiménez-Serrano, José L. Leyva-Pons, Asalea B. López-Cuellar, Julio López-Cuellar, Juan Manuel López-Quijano, Héctor López-Torres, Guillermo A. Llamas‐Esperón, Lecsy Macedo-Calvillo, José Antonio Magaña-Serrano, Francisco J. Martín-de-la-Torre, Jerónimo Enrique Martínez-Flores, Alejandra Meaney-Martínez, Celso Mendoza-González, José A. Merino-Rajme, Felicia Millán-Gómez, Luis G. Molina-Fernández-de-Lara, Maricruz Moreno-Álvarez, Jorge A. Moscoso-Maza, Guillermo L. Naranjo-Ricoy, Santiago Nava-Townsend, Fidel Ortiz-Alcalá, Fernando Ortiz‐Galván, Abel A. Pavia-López, Juan Carlos Pérez-Alva, José Manuel Portos-Silva, Gerardo Pozas-Garza, Juan C. Ramírez-Ruvalcaba, Marco Antonio Ramos-Corrales, Marco Ramos-García, Fernando A. Reyes-Cisneros, Rogelio Robledo‐Nolasco, Francisco J. Robles-Torres, Gerardo Rodríguez-Diez, Ignacio Rodríguez-Briones, Jaqueline M. Rosado-Matos, Carlos Sanchez-Diaz, Jesús Siller-Rodríguez, Joaquín Vargas-Peñafiel, José L. Zacarías-Martín, José G. Zúñiga-Sedano,

Cardiac Imaging and Diagnostics

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. 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. 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). 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.