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

Clin Res Cardiol. 2019 Dec;108(12):1371-1380. doi: 10.1007/s00392-019-01473-3. Epub 2019 Apr 5.

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: All-cause mortality; Arial fibrillation; Body mass index.

Publication types

  • Comparative Study
  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / mortality*
  • Body Mass Index*
  • Cause of Death
  • China / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / diagnosis
  • Obesity / mortality*
  • Prognosis
  • Prospective Studies
  • Protective Factors
  • Registries
  • Risk Assessment
  • Risk Factors
  • Thinness / diagnosis
  • Thinness / mortality*
  • Time Factors