Clinical Outcomes in Metabolically Healthy and Unhealthy Obese and Overweight Patients With Atrial Fibrillation: Findings From the GLORIA-AF Registry.

Corica, Bernadette ORCID: 0000-0001-9460-4435, Romiti, Giulio Francesco, Proietti, Marco, Mei, Davide Antonio, Boriani, Giuseppe, Chao, Tze-Fan, Olshansky, Brian, Huisman, Menno V, Lip, Gregory YH ORCID: 0000-0002-7566-1626 and GLORIA-AF Investigators, (2023) Clinical Outcomes in Metabolically Healthy and Unhealthy Obese and Overweight Patients With Atrial Fibrillation: Findings From the GLORIA-AF Registry. Mayo Clinic proceedings. S0025-6196(23)00347-6-.

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Official URL: http://dx.doi.org/10.1016/j.mayocp.2023.07.013

Abstract

<h4>Objective</h4>To explore the association between metabolic status, body mass index (BMI), and natural history of patients with atrial fibrillation (AF).<h4>Methods</h4>The global, prospective GLORIA-AF Registry Phase II and III included patients with recent diagnosis of AF between November 2011 and December 2014 for Phase II and between January 2014 and December 2016 for Phase III. With this analysis, we categorized patients with AF according to BMI (normal weight [18.5 to 24.9 kg/m<sup>2</sup>], overweight [25.0 to 29.9 kg/m<sup>2</sup>], obese [30.0 to 60.0 kg/m<sup>2</sup>]) and metabolic status (presence of hypertension, diabetes, and hyperlipidemia). We analyzed risk of major outcomes using multivariable Cox regression analyses; the primary outcome was the composite of all-cause death and major adverse cardiovascular events.<h4>Results</h4>There were 24,828 (mean age, 70.1±10.3 years; 44.6% female) patients with AF included. Higher BMI was associated with metabolically unhealthy status and higher odds of receiving oral anticoagulants and other treatments. Normal-weight unhealthy patients showed a higher risk of the primary composite outcome (adjusted hazard ratio [aHR], 1.20; 95% CI, 1.01 to 1.42) and thromboembolism, whereas a lower risk of cardiovascular death (aHR, 0.35; 95% CI, 0.14 to 0.88) and major adverse cardiovascular events (aHR, 0.56; 95% CI, 0.33 to 0.93) was observed in metabolically healthy obese individuals. Unhealthy metabolic groups were also associated with increased risk of major bleeding (aHR, 1.51 [95% CI, 1.04 to 2.20] and aHR, 1.96 [95% CI, 1.34 to 2.85] in overweight and obese groups, respectively).<h4>Conclusion</h4>Increasing BMI was associated with poor metabolic status and with more intensive treatment. Prognosis was heterogeneous between BMI groups, with metabolically unhealthy patients showing higher risk of adverse events.

Item Type:	Article
Uncontrolled Keywords:	GLORIA-AF Investigators
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	05 Sep 2023 14:53
Last Modified:	05 Sep 2023 14:54
DOI:	10.1016/j.mayocp.2023.07.013
Open Access URL:	https://doi.org/10.1016/j.mayocp.2023.07.013
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3172565