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Body mass index and all-cause mortality in patients with atrial fibrillation: insights from the China atrial fibrillation registry study

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Abstract

Background

Impact of body mass index (BMI) on all-cause mortality in atrial fibrillation (AF) patients remains controversial.

Methods

A total of 10,942 AF patients were prospectively enrolled and categorized into four BMI groups: underweight (BMI < 18.5 kg/m2), normal weight (BMI 18.5–24 kg/m2), overweight (BMI 24–28 kg/m2) and obesity (BMI ≥ 28 kg/m2). The primary outcome was all-cause mortality. Different Cox proportional hazards models were performed to evaluate the association between BMI and all-cause mortality.

Results

During a median follow-up of 30 months (IQR 18–48 months), 862 deaths events occurred. Compared to normal BMI, higher BMI was associated with a lower mortality risk (overweight: HR 0.70; 95% CI 0.61–0.81, P < 0.0001 and obesity: HR 0.54; 95% CI 0.44–0.67, P < 0.0001) and lower BMI was associated with a higher mortality risk (HR 2.23, 95% CI 1.67–2.97, P < 0.0001).

Conclusion

A reversed relationship between BMI and all-cause mortality in AF patients was found. Higher risk of mortality was observed in underweight patients compared to patients with a normal BMI, while overweight and obese patients had a lower risk of all-cause mortality.

Clinical trial registration

URL: http://www.chictr.org.cn/showproj.aspx?proj=5831. Unique identifier: ChiCTR-OCH-13003729.

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Acknowledgements

We sincerely thank all the hospitals which involved in the China-AF study.

Funding

This work was supported by the National Key Research and Development Program of China (2016YFC0900901, 2016YFC1301002), Grant from the National Science Foundation of China (81530016), and Grants from Beijing Municipal Commission of Science and Technology (D151100002215003, D151100002215004).

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Authors and Affiliations

  1. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, No. 2 Beijing Anzhen Road, Chaoyang District, Beijing, 100029, China

    Lu Wang, Xin Du, Jian-Zeng Dong, Song-Nan Li, Xue-Yuan Guo, Chen-Xi Jiang, Rong-Hui Yu, Cai-Hua Sang, Ri-Bo Tang, De-Yong Long, Nian Liu, Rong Bai & Chang-Sheng Ma

  2. Heart Health Research Center, Beijing, China

    Xin Du

  3. University of New South Wales, Sydney, Australia

    Xin Du

  4. Cardiovascular Hospital, First Affiliated Hospital of Zhengzhou University, No. 2 Building East Road, Zhengzhou, 450052, Henan, China

    Jian-Zeng Dong

  5. School of Statistics, Faculty of Economics and Management, East China Normal University, Shanghai, China

    Wen-Na Liu & Ying-Chun Zhou

  6. Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada

    Laurent Macle

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  1. Lu Wang
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Corresponding author

Correspondence to Jian-Zeng Dong.

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Conflict of interest

Dr. Jian-Zeng Dong received honoraria from Johnson & Johnson for giving lectures. Dr. Chang-Sheng Ma received honoraria from Bristol-Myers Squibb (BMS), Pfizer, Johnson & Johnson, Boehringer-Ingelheim (BI), and Bayer for giving lectures. The other authors report no conflicts of interest.

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Wang, L., Du, X., Dong, JZ. et al. Body mass index and all-cause mortality in patients with atrial fibrillation: insights from the China atrial fibrillation registry study. Clin Res Cardiol 108, 1371–1380 (2019). https://doi.org/10.1007/s00392-019-01473-3

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  • DOI: https://doi.org/10.1007/s00392-019-01473-3

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