geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Influence of obesity on outcomes in atrial fibrillation: yet another obesity paradox


, : Influence of obesity on outcomes in atrial fibrillation: yet another obesity paradox. American Journal of Medicine 123(7): 646-651

Obese patients have favorable outcomes in congestive heart failure, hypertension, peripheral vascular disease, and coronary artery disease. Obesity also has been linked with increased incidence of atrial fibrillation, but its influence on outcomes in atrial fibrillation patients has not been investigated. The objective of this research is to investigate the effect of obesity on outcomes in atrial fibrillation. The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study was one of the largest multicenter trials of atrial fibrillation, with 4060 patients. Subjects were randomized to rate versus rhythm-control strategy. We performed a post hoc analysis of the National Heart, Lung and Blood Institute limited access dataset of atrial fibrillation patients who had body mass index (BMI) data available in the AFFIRM study. BMI data were not available on 1542 patients. Patients with BMI >or=18.5 were split into normal (18.5-25), overweight (25-30), and obese (>30) categories as per BMI (kg/m(2)). Multivariate Cox proportional hazards regression was used on the eligible 2492 patients. End points were all-cause mortality and cardiovascular mortality. Over three fourths of all patients in our cohort were overweight or obese. There were 304 deaths (103 among normal weight, 108 among overweight, and 93 among obese) and 148 cardiovascular deaths (54 among normal weight, 41 among overweight, and 53 among obese) over a mean period of 3 years of patient follow-up. On multivariate analysis, overweight (hazard ratio [HR] 0.64; 95% confidence interval [CI], 0.48-0.84; P=.001) and obese (HR 0.80; 95% CI, 0.68-0.93; P=.005) categories were associated with lower all-cause mortality as compared with normal weight. Overweight (HR 0.40; 95% CI, 0.26-0.60; P <.001) and obese patients (HR 0.77; 95% CI, 0.62-0.95; P=.01) also had lower cardiovascular mortality as compared with the normal weight patients. Although in prior studies, obesity has been associated with increased risk of atrial fibrillation, an obesity paradox exists for outcomes in atrial fibrillation. Obese patients with atrial fibrillation appear to have better long-term outcomes than nonobese patients.

US$19.90

PMID: 20609687

DOI: 10.1016/j.amjmed.2009.11.026


Other references

Meseguer-Olmo, L.; Ros-Nicolás, M.; Vicente-Ortega, V.; Alcaraz-Baños, M.; Clavel-Sainz, M.; Arcos, D.; Ragel, C.V.; Vallet-Regí, M.; Meseguer-Ortiz, C., 2006: A bioactive sol-gel glass implant for in vivo gentamicin release. Experimental model in Rabbit. Biomaterial pieces with osteogenic properties, suitable for use in the treatment of bone defects, were synthesized. The materials, which avoid bone infections, are exclusively composed of gentamicin sulfate and bioactive SiO2-CaO-P2O5 sol-gel glas...

Boca, R.; Gembický, M.; Herchel, R.; Haase, W.; Jäger, L.; Wagner, C.; Ehrenberg, H.; Fuess, H., 2003: Ferromagnetism in a dinuclear nickel(II) complex containing triethylenetetramine and tricyanomethanide. Triethylenetetramine (L(4)) was used as a tetradentate blocking ligand that, after complexation with Ni(II), leaves two sites ready for ligation with tricyanomethanide. The formed binuclear complex [L(4)Ni(NCC(CN)CN)(2)NiL(4)](ClO(4))(2) exhibits...

Endröczi, E., 1983: Physiological and clinical significance of opio-melanocortin peptides. Orvosi Hetilap 124(12): 679-682

Babino, D.; Perkins, B.D.; Kindermann, A.; Oberhauser, V.; von Lintig, J., 2015: The role of 11-cis-retinyl esters in vertebrate cone vision. A cycle of cis-to-trans isomerization of the chromophore is intrinsic to vertebrate vision where rod and cone photoreceptors mediate dim- and bright-light vision, respectively. Daylight illumination can greatly exceed the rate at which the photopr...

Fritschy, J.M.; Frondoza, C.G.; Grzanna, R., 1991: Differential effects of reserpine on brainstem catecholaminergic neurons revealed by Fos protein immunohistochemistry. The effects of a single systemic injection of reserpine on c-fos proto-oncogene expression in catecholaminergic neurons of the rat brainstem were studied by immunohistochemistry for Fos proteins (Fos). In control rats, a few Fos immunoreactive neu...

Picard, N.; Mortier, F.; Chagneau, P., 2008: Influence of estimators of the vital rates in the stock recovery rate when using matrix models for tropical rainforests. The stock recovery rate, the ratio of the wood stock at the end of a felling cycle over the wood stock just before logging, is a key parameter for the management of tropical rainforests. It is thus essential to predict it with a reliable precisio...

Bohl, D.; Jackson, G., 2006: Experimental study of the spill and vaporization of a volatile liquid. Pool and vapor cloud characteristics of an acetone spill issuing from the downstream wall of a flow obstruction oriented perpendicular to a uniform flow were investigated experimentally. Data indicate that the spill event was largely governed by t...

Cotlier, E.; Kwan, B.; Beaty, C., 1968: The lens as an osmometer and the effects of medium osmolarity on water transport, 86Rb efflux and 86Rb transport by the lens. Biochimica et Biophysica Acta 150(4): 705-722

Chavtur V.G., 1984: Ostracods of the family polycopidae cladocopina of the far east seas and adjacent pacific regions. Species (41) of the Polycopida were registered in the Far East seas and adjacent oceanic waters. Illustrated descriptions are provided for Pseudopolycope shornikovi sp. nov., P. intermis sp. nov. and Micropolycope aliena sp. nov. A key is given wi...

Ochi, K.; Miyamoto, Y.; Ohashi, T., 2003: Pediatric bilateral facial nerve palsy secondary to acute otitis media. Bilateral facial palsy after the onset of acute otitis media is presented in a 19-month-old patient. Facial nerve palsy disappeared gradually after myringotomy. The mechanisms underlying the facial nerve palsy with otitis media are discussed.