Clinical Research in Cardiology

, Volume 103, Issue 7, pp 533–542 | Cite as

Overweight is associated with improved survival and outcomes in patients with atrial fibrillation

  • Juan Wang
  • Yan-min YangEmail author
  • Jun ZhuEmail author
  • Han Zhang
  • Xing-hui Shao
  • Li Tian
  • Bi Huang
  • Li-tian Yu
  • Xin Gao
  • Man Wang
Original Paper



The aim of this study was to investigate the association of body mass index (BMI) with mortality and cardiovascular events in Chinese patients with atrial fibrillation (AF).

Methods and results

This study consecutively enrolled AF patients presenting to an emergency department at 20 hospitals in China from November 2008 to October 2011. A total of 2,016 AF patients was enrolled, and patients were categorized as underweight (BMI <18.5), normal (BMI 18.5 to <24), overweight (BMI 24 to <28), and obese (BMI ≥28 all kg/m2). Multivariate Cox proportional hazards regression was used on all the patients. End points of the analyses were all-cause mortality, cardiovascular mortality, and combined end events. Among overall patients, mean BMI was 23.5 ± 3.6 kg/m2; 279 (13.8 %) patients died during 12-month follow-up, and so did 23.2 % underweight, 16.3, 9.5 and 9.2 % normal weight, overweight, and obese patients, respectively (P < 0.001). Cardiovascular mortality was 8.3% in all patients, and in underweight, normal weight, overweight and obese categories were 16.5, 9.0, 5.4 and 6.9 %, respectively (P < 0.001). On multivariate analysis, as continuous variable, BMI was not a risk factor for all-cause mortality in AF patients (hazard ratio [HR] 0.94; 95 % confidence interval [CI] 0.91–0.97; P = 0.001). As categorical variable, underweight (HR 1.57, 95 % CI 1.02–2.42, P = 0.041) and normal weight (HR 1.53, 95 % CI 1.13–2.06, P = 0.005) categories were associated with higher all-cause mortality as compared with overweight category. Underweight (HR 2.01, 95 % CI 1.76–3.43, P = 0.011) and normal weight patients (HR 1.53, 95 % CI 1.03–2.28, P = 0.037) also had higher cardiovascular mortality as compared with the overweight category.


Obesity and overweight were not risk factors for 12-month mortality in Chinese AF patients. Overweight AF patients have better survival and outcomes than normal weight (BMI 18.5–24 kg/m2) and underweight patients.


Atrial fibrillation Body mass index Obesity Overweight Mortality Combined end events 



All authors have read and approved submission of the manuscript and the mention of their names.

Conflict of interest

None declared.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Juan Wang
    • 1
  • Yan-min Yang
    • 1
    Email author
  • Jun Zhu
    • 1
    Email author
  • Han Zhang
    • 1
  • Xing-hui Shao
    • 1
  • Li Tian
    • 1
  • Bi Huang
    • 1
  • Li-tian Yu
    • 1
  • Xin Gao
    • 1
  • Man Wang
    • 1
  1. 1.Emergency and Intensive Care Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular DiseaseChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina

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