The ‘obesity paradox’ in atrial fibrillation: observations from the ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) trial
Authors' conclusion
In patients with AF treated with oral anticoagulants, higher BMI and WC are associated with a more favourable prognosis.
Study context
- Population
- Atrial fibrillation (AF) patients treated with oral anticoagulation in the ARISTOTLE trial, body mass index (BMI) measured at baseline
- Participants
- 17,913 patients
- Comparison
- Overweight and obese BMI vs normal BMI
- Normaln = 4,052reference
- Overweightn = 6,702
- Obesen = 7,159
Primary result
As reported in the abstract
Each group vs normalHazard ratio (95% CI)P value
Overweightall-cause mortality
0.67(0.59–0.78)
P < 0.0001Obeseall-cause mortality
0.63(0.54–0.74)
P < 0.0001Overweightcomposite endpoint
0.74(0.65–0.84)
P < 0.0001Obesecomposite endpoint
0.68(0.60–0.78)
P < 0.0001Further findings
High waist circumference (WC) (>88 cm) in women
- Lower risk of all-cause mortality
- 31% (P = 0.001)
- Lower risk of composite endpoint
- 27% (P = 0.001)
- Lower risk of stroke or systemic embolism
- 28% (P = 0.048)
- No such association in men
Safety
- No significant association between adiposity and major bleeding
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
The ‘obesity paradox’ in atrial fibrillation: observations from the ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) trial. Eur Heart J. Published 12 April 2016. doi:10.
Summarised from the published abstract; every number is checked against it