Body Mass Index and Adverse Outcomes in Elderly Patients With Atrial Fibrillation: The AMADEUS Trial.

Abstract

BACKGROUND AND PURPOSE:

Obesity has been associated with increased cardiovascular risk in atrial fibrillation, but little is known in elderly patients with atrial fibrillation.

METHODS:

Post hoc analysis of data from the AMADEUS (Evaluating the Use of SR34006 Compared to Warfarin or Acenocoumarol in Patients With Atrial Fibrillation) trial.

RESULTS:

We studied 1588 elderly patients, who were categorized as normal body mass index (BMI, 18.5-25 kg/m(2); n=515 [32.4%]), overweight (BMI, 25-30 kg/m(2); n=711 [44.8%]), and obese (BMI≥30 kg/m(2); n=362 [22.8%]). There was a significant reduction in the composite outcome of cardiovascular death and stroke/systemic embolism with increasing BMI category, being 5.0%, 3.2%, and 1.5% per 100 patient-years, respectively (P for trend=0.01). Cox proportional hazards analysis found obesity to be associated with a lower risk of the primary composite outcome (hazard ratio, 0.29; 95% confidence interval, 0.11-0.77; P=0.01). In the warfarin arm (n=814), multivariate logistic regression analysis demonstrated that obesity was independently related to higher odds of time in therapeutic range ≥60% (odds ratio, 1.84; 95% confidence interval, 1.21-2.80; P=0.004).

CONCLUSION:

Obesity was associated with a lower stroke and mortality rate in elderly anticoagulated atrial fibrillation patients. Obesity was related to good quality anticoagulation control.

• Authors: Keitaro Senoo, Gregory Y H Lip
• Journal: Stroke (Stroke) Vol. 47 Issue 2 Pg. 523-6 (Feb 2016) ISSN: 1524-4628 [Electronic] United States
• PMID: 26628383 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 American Heart Association, Inc.

Chemical References

• Anticoagulants
• Factor Xa Inhibitors
• Oligosaccharides
• Warfarin
• idraparinux

Topics

• Aged
• Aged, 80 and over
• Anticoagulants (therapeutic use)
• Atrial Fibrillation (complications, drug therapy, epidemiology)
• Body Mass Index
• Cardiovascular Diseases (mortality)
• Case-Control Studies
• Comorbidity
• Embolism (etiology, prevention & control)
• Factor Xa Inhibitors (therapeutic use)
• Female
• Humans
• Logistic Models
• Male
• Multivariate Analysis
• Obesity (epidemiology)
• Oligosaccharides (therapeutic use)
• Overweight (epidemiology)
• Proportional Hazards Models
• Risk Factors
• Stroke (epidemiology, etiology, prevention & control)
• Warfarin (therapeutic use)