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Body mass index and all-cause mortality in patients with atrial fibrillation: insights from the China atrial fibrillation registry study

  • Lu Wang
  • Xin Du
  • Jian-Zeng DongEmail author
  • Wen-Na Liu
  • Ying-Chun Zhou
  • Song-Nan Li
  • Xue-Yuan Guo
  • Chen-Xi Jiang
  • Rong-Hui Yu
  • Cai-Hua Sang
  • Ri-Bo Tang
  • De-Yong Long
  • Nian Liu
  • Rong Bai
  • Laurent Macle
  • Chang-Sheng Ma
Original Paper

Abstract

Background

Impact of body mass index (BMI) on all-cause mortality in atrial fibrillation (AF) patients remains controversial.

Methods

A total of 10,942 AF patients were prospectively enrolled and categorized into four BMI groups: underweight (BMI < 18.5 kg/m2), normal weight (BMI 18.5–24 kg/m2), overweight (BMI 24–28 kg/m2) and obesity (BMI ≥ 28 kg/m2). The primary outcome was all-cause mortality. Different Cox proportional hazards models were performed to evaluate the association between BMI and all-cause mortality.

Results

During a median follow-up of 30 months (IQR 18–48 months), 862 deaths events occurred. Compared to normal BMI, higher BMI was associated with a lower mortality risk (overweight: HR 0.70; 95% CI 0.61–0.81, P < 0.0001 and obesity: HR 0.54; 95% CI 0.44–0.67, P < 0.0001) and lower BMI was associated with a higher mortality risk (HR 2.23, 95% CI 1.67–2.97, P < 0.0001).

Conclusion

A reversed relationship between BMI and all-cause mortality in AF patients was found. Higher risk of mortality was observed in underweight patients compared to patients with a normal BMI, while overweight and obese patients had a lower risk of all-cause mortality.

Clinical trial registration

URL: http://www.chictr.org.cn/showproj.aspx?proj=5831. Unique identifier: ChiCTR-OCH-13003729.

Keywords

Body mass index Arial fibrillation All-cause mortality 

Notes

Acknowledgements

We sincerely thank all the hospitals which involved in the China-AF study.

Funding

This work was supported by the National Key Research and Development Program of China (2016YFC0900901, 2016YFC1301002), Grant from the National Science Foundation of China (81530016), and Grants from Beijing Municipal Commission of Science and Technology (D151100002215003, D151100002215004).

Compliance with ethical standards

Conflict of interest

Dr. Jian-Zeng Dong received honoraria from Johnson & Johnson for giving lectures. Dr. Chang-Sheng Ma received honoraria from Bristol-Myers Squibb (BMS), Pfizer, Johnson & Johnson, Boehringer-Ingelheim (BI), and Bayer for giving lectures. The other authors report no conflicts of interest.

Supplementary material

392_2019_1473_MOESM1_ESM.docx (17 kb)
Supplementary material 1 (DOCX 17 kb)
392_2019_1473_MOESM2_ESM.docx (16 kb)
Supplementary material 2 (DOCX 15 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Lu Wang
    • 1
  • Xin Du
    • 1
    • 2
    • 3
  • Jian-Zeng Dong
    • 1
    • 4
    Email author
  • Wen-Na Liu
    • 5
  • Ying-Chun Zhou
    • 5
  • Song-Nan Li
    • 1
  • Xue-Yuan Guo
    • 1
  • Chen-Xi Jiang
    • 1
  • Rong-Hui Yu
    • 1
  • Cai-Hua Sang
    • 1
  • Ri-Bo Tang
    • 1
  • De-Yong Long
    • 1
  • Nian Liu
    • 1
  • Rong Bai
    • 1
  • Laurent Macle
    • 6
  • Chang-Sheng Ma
    • 1
  1. 1.Department of Cardiology, Beijing Anzhen HospitalCapital Medical University, National Clinical Research Centre for Cardiovascular DiseasesBeijingChina
  2. 2.Heart Health Research CenterBeijingChina
  3. 3.University of New South WalesSydneyAustralia
  4. 4.Cardiovascular HospitalFirst Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
  5. 5.School of Statistics, Faculty of Economics and ManagementEast China Normal UniversityShanghaiChina
  6. 6.Montreal Heart InstituteUniversité de MontréalMontrealCanada

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