The obesity paradox for outcomes in atrial fibrillation: Evidence from an exposure‐effect analysis of prospective studies

Liu, Xiao; Guo, Lina; Xiao, Kan; Zhu, Wenzhen; Liu, Menglu; Wan, Rong; Hong, Kui

doi:10.1111/obr.12970

Cited by 45 publications

(52 citation statements)

References 74 publications

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“…The present study found that an increase in BMI is an important risk factor for IS in NVAF patients. Previous studies have shown that BMI is negatively correlated with IS in AF patients [27], which is contrary to the results of the present study. At present, the relationship between obesity and IS remains controversial [27][28].…”

Section: Discussioncontrasting

confidence: 99%

“…Previous studies have shown that BMI is negatively correlated with IS in AF patients [27], which is contrary to the results of the present study. At present, the relationship between obesity and IS remains controversial [27][28]. Large-scale and prospective studies are needed to further explore the impact of BMI on adverse event outcomes in AF patients.…”

Section: Discussioncontrasting

confidence: 99%

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LDL-C/HDL-C is Associated With Ischaemic Stroke in Patients With Non-Valvular Atrial Fibrillation: A Case-Control Study

Zhang

Meng

Shang

et al. 2020

Preprint

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Background This study explored relationships between low-/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and other clinical indicators and ischaemic stroke (IS) in non-valvular atrial fibrillation (NVAF) patients in Xinjiang, which could provide a theoretical and therapeutic basis for patients with NVAF. Methods NVAF patients who were admitted to 10 medical centres across Xinjiang were divided into the stroke (798 patients) and control (2671 patients) groups according to whether acute IS occurred. Univariate and multivariate logistic regression analysis was used to examine the independent risk factors for IS in NVAF patients. We used factor analysis and principal component regression analysis to analyse the main influencing factors of IS. Receiver operating characteristic (ROC) curve analysis was used to evaluate the optimal cut-off value of LDL-C/HDL-C in predicting IS. Results Multivariate logistic regression showed that the risk of IS in the highest quartile of LDL-C/HDL-C (≥ 2.73) was 16.23-fold that in the lowest quartile (< 1.22); IS risk was 2.27-fold higher in obese patients (BMI ≥ 28 kg/m2) than in normal-weight subjects; IS risk was 3.15-fold higher in smoking than in non-smoking patients. The area under the ROC curve of LDL-C/HDL-C was 0.76, optimal critical value was 2.33, sensitivity was 63.53%, and specificity was 76.34%. Principal component regression analysis showed that LDL-C/HDL-C, age, smoking, drinking, LDL-C and hypertension were risk factors for IS in NVAF patients. Conclusions LDL-C/HDL-C > 1.22, smoking and BMI ≥ 24 kg/m2 were independent risk factors for IS in NVAF patients, of which LDL-C/HDL-C was the main risk factor.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 99%

LDL-C/HDL-C is Associated With Ischaemic Stroke in Patients With Non-Valvular Atrial Fibrillation: A Case-Control Study

Zhang

Meng

Shang

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Previous studies have shown that BMI is negatively correlated with IS in AF patients [42], which is contrary to the results of the present study. At present, the relationship between obesity and IS remains controversial [42][43]. Large sample, multicentre and prospective studies are needed to further explore the relationship between BMI and serum lipids and the in uence of this relationship on adverse event outcomes in AF patients.…”

Section: Discussioncontrasting

confidence: 99%

LDL-C/HDL-C is associated with ischaemic stroke in patients with non-valvular atrial fibrillation: a case-control study

Zhang

Meng

Shang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: This study explored the relationships between the low-/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and other clinical indicators and ischaemic stroke (IS) in patients with non-valvular atrial fibrillation (NVAF) in Xinjiang. The findings could provide a theoretical and therapeutic basis for NVAF patients.Methods: NVAF patients who were admitted to 10 medical centres across Xinjiang were divided into stroke (798 patients) and control (2671 patients) groups according to the occurrence of first acute IS occurred. Univariate and multivariate logistic regression analysis were used to examine the independent risk factors for IS in NVAF patients. Factor analysis and principal component regression analysis were used to analyse the main factors influencing IS. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminatory ability of LDL-C/HDL-C for predicting the occurrence of IS.Results: The stroke group had an average age of 71.64 ± 9.96 years and included 305 females (38.22%). The control group had a mean age of 67.30 ± 12.01 years and included 825 females (30.89%). Multivariate logistic regression showed that the risk of IS in the highest LDL-C/HDL-C quartile ( ≥2.73) was 16.23-fold that of the lowest quartile ( < 1.22); IS risk was 2.27-fold higher in obese patients than in normal-weight subjects; IS risk was 3.15-fold higher in smoking patients than in non-smoking patients. The area under the ROC curve of LDL-C/HDL-C was 0.76, the optimal critical value was 2.33, the sensitivity was 63.53%, and the specificity was 76.34%. Principal component regression analysis showed that LDL-C/HDL-C, age, smoking, drinking, LDL-C and hypertension were risk factors for IS in NVAF patients.Conclusions: LDL-C/HDL-C >1.22, smoking, BMI ≥24 kg/m2 and CHA2DS2-VASc score were independent risk factors for IS in NVAF patients; LDL-C/HDL-C was the main risk factor.

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“…Obesity has been reported as an independent risk factor for new‐onset AF, being associated with a 20% higher risk of AF than normal weight 4 . However, a number of clinical studies and meta‐analyses found that compared with patients with normal weight, patients with overweight or obesity did not have worse or even better outcomes among patients with AF, known as the “obesity paradox.” 5‐7 This phenomenon was also found in patients with obesity and other diseases; for example, in studies examining the rate of complications in patients undergoing percutaneous coronary intervention, the rate of complications was paradoxically found to decrease in patients with mild/moderate obesity 8,9 …”

Section: Introductionmentioning

confidence: 93%

Impact of body mass index on procedural complications, procedure duration, and radiation dose in patients with atrial fibrillation undergoing radiofrequency ablation: A systematic review and meta‐analysis

Liu

Mei

Liu

et al. 2020

Clinical Cardiology

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Background: The association of body mass index (BMI) and procedure-related factors in patients with atrial fibrillation (AF) after radiofrequency ablation (RFA) is still unclear. Hypothesis: BMI is associated with increased the radiation dose, procedure duration, and procedural complications. Methods: Prospective studies assessing BMI and procedure duration, radiation dose, and procedural complications in patients with AF after RFA were identified through electronic searches of PubMed, Embase, and the Cochrane Library database. Results: Ten studies with 14 735 participants undergoing RFA were included. Procedure duration was significantly longer in patients with overweight or obesity than in patients with normal BMI, with a mean difference (MD) of 0.95. Patients with overweight and obesity were exposed to a larger radiation dose, with standard MD of 1.71 and 1.98, respectively. There was no significant association between overweight or obesity and the risk of procedural complications (RR of 0.91 for overweight, 1.01 for obesity, 0.89 for stage I obesity, 1.00 for stage II obesity, and 0.94 for stage III obesity). Further analysis showed there was no significant difference regarding stroke or transient ischemic attack (

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The obesity paradox for outcomes in atrial fibrillation: Evidence from an exposure‐effect analysis of prospective studies

Cited by 45 publications

References 74 publications

LDL-C/HDL-C is Associated With Ischaemic Stroke in Patients With Non-Valvular Atrial Fibrillation: A Case-Control Study

LDL-C/HDL-C is Associated With Ischaemic Stroke in Patients With Non-Valvular Atrial Fibrillation: A Case-Control Study

LDL-C/HDL-C is associated with ischaemic stroke in patients with non-valvular atrial fibrillation: a case-control study

Impact of body mass index on procedural complications, procedure duration, and radiation dose in patients with atrial fibrillation undergoing radiofrequency ablation: A systematic review and meta‐analysis

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