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Impact of age on the association between body mass index and all-cause mortality in patients with atrial fibrillation

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

To explore the impact of age on the association between body mass index (BMI) and all-cause mortality in patients with atrial fibrillation (AF).

Methods

A total of 1991 patients with AF (69 ± 13 years, 54.9% female) were divided into three age groups: < 65 years, 65-75 years, and > 75 years, and followed for one year. The primary outcome was defined as all-cause mortality, with secondary outcomes including thromboembolism and major bleeding. Cox regression models were utilized to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

Compared to patients aged < 65 years, elder groups had much lower BMI and more comorbidities other than a lower prevalence of valvular heart disease. During one-year follow-up, 277 (13.9%) patients died, 158 (7.9%) underwent thromboembolism events and 26 (1.3%) had major bleeding. Mortality and thromboembolism risk were both notably higher in patients with advanced age (all P values < 0.001). Using normal weight patients as reference, mortality risk was significantly lower in overweight (HR 0.548; 95% CI 0.404-0.744) and obese patients (HR 0.536; 95% CI 0.325-0.883) for the entire cohort, with reduced death risk mainly observed in overweight patients aged 65-75 years (HR 0.285; 95% CI 0.131-0.621) and aged > 75 years (HR 0.686; 95% CI 0.473-0.993), but not in patients aged < 65 years. Continuous analyses of BMI indicated consistent results.

Conclusion

High BMI is associated with reduced mortality rate in patients with AF, and this association is affected by age, with the so-called “obesity paradox” confined to those with advanced age rather than young patients.

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Authors and Affiliations

  1. Emergency and Intensive Care Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People’s Republic of China

    S. Wu, Yan-min Yang, J. Zhu, H.-B. Wan, J. Wang, H. Zhang & X.-H. Shao

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  1. S. Wu
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  2. Yan-min Yang
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  3. J. Zhu
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  4. H.-B. Wan
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  6. H. Zhang
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  7. X.-H. Shao
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Correspondence to Yan-min Yang.

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Wu, S., Yang, Ym., Zhu, J. et al. Impact of age on the association between body mass index and all-cause mortality in patients with atrial fibrillation. J Nutr Health Aging 21, 1125–1132 (2017). https://doi.org/10.1007/s12603-016-0863-2

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  • DOI: https://doi.org/10.1007/s12603-016-0863-2

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