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The “Obesity Paradox” and the Use of NOAC

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Direct Oral Anticoagulants

Abstract

Obesity is a worldwide health problem at increasing incidence associated with high morbidity and mortality. Although obesity increases patients’ cardiovascular (CV) risk, more and more evidences suggest a favorable prognosis in obese subjects with cardiovascular disease (CVD), a phenomenon known as “obesity paradox.” Obesity paradox has been demonstrated in various CVD including atrial fibrillation (AF) and venous thromboembolism (VTE) for which anticoagulation therapy is mandatory. Little is still known about the use of non-vitamin K oral anticoagulants (NOACs) in extreme obese patients, so major guidelines discourage their use in this subset of patients. Due to the lack of data and clinical interest of the topic, we aim to review the concept of obesity paradox applied to AF and VTE, for then examine the available data on the prognosis of obese patients being treated with NOACs.

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Authors and Affiliations

  1. Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, Naples, Italy

    Roberta Bottino, Andreina Carbone, Paolo Golino, Gerardo Nigro & Vincenzo Russo

  2. Department of Cardiology, Monaldi Hospital, Naples, Italy

    Biagio Liccardo

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  1. Roberta Bottino
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  2. Andreina Carbone
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  3. Biagio Liccardo
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  4. Paolo Golino
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  5. Gerardo Nigro
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  6. Vincenzo Russo
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Editor information

Editors and Affiliations

  1. Cardiac Rehabilitation Unit Ospedale, Sacra Famiglia Fatebenefratelli, Erba, Italy

    Riccardo Proietti

  2. McGill University, Montreal, QC, Canada

    Ahmed AlTurki

  3. Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padova, Italy

    Nicola Ferri

  4. Department of Medical Translational Sciences, University of Campania “Luigi Vanvitelli” - Monaldi Hospital, Naples, Italy

    Vincenzo Russo

  5. Division of Cardiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA

    T. Jared Bunch

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Bottino, R., Carbone, A., Liccardo, B., Golino, P., Nigro, G., Russo, V. (2021). The “Obesity Paradox” and the Use of NOAC. In: Proietti, R., AlTurki, A., Ferri, N., Russo, V., Bunch, T.J. (eds) Direct Oral Anticoagulants. Springer, Cham. https://doi.org/10.1007/978-3-030-74462-5_9

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