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Obesity paradox on ...
Obesity paradox on outcome in atrial fibrillation maintained even considering the prognostic influence of biomarkers : insights from the ARISTOTLE trial
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- Sandhu, Roopinder K. (author)
- Univ Alberta, Mazankowski Alberta Heart Inst, Edmonton, AB, Canada;Univ Alberta, Canadian VIGOUR Ctr, Edmonton, AB, Canada
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- Ezekowitz, Justin A. (author)
- Univ Alberta, Mazankowski Alberta Heart Inst, Edmonton, AB, Canada;Univ Alberta, Canadian VIGOUR Ctr, Edmonton, AB, Canada
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- Hijazi, Ziad (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Westerbergh, Johan (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Aulin, Julia (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Alexander, John H. (author)
- Duke Clin Res Inst, Duke Med, Durham, NC USA
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- Granger, Christopher B. (author)
- Duke Clin Res Inst, Duke Med, Durham, NC USA
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- Halvorsen, Sigrun (author)
- Oslo Univ Hosp Ulleval, Dept Cardiol, Oslo, Norway;Univ Oslo, Oslo, Norway
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- Hanna, Michael S. (author)
- Bristol Myers Squibb, Princeton, NJ USA
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- Lopes, Renato D. (author)
- Duke Clin Res Inst, Duke Med, Durham, NC USA
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- Siegbahn, Agneta, 1947- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Klinisk kemi
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- Wallentin, Lars, 1943- (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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(creator_code:org_t)
- 2018-11-01
- 2018
- English.
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In: Open heart. - : BMJ. - 2053-3624. ; 5:2
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Abstract
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- ObjectiveWe investigated the association between obesity and biomarkers indicating cardiac or renal dysfunction or inflammation and their interaction with obesity and outcomes.MethodsA total of 14 753 patients in the Apixaban for Reduction In STroke and Other ThromboemboLic Events in Atrial Fibrillation (ARISTOTLE) trial provided plasma samples at randomisation to apixaban or warfarin. Median follow-up was 1.9 years. Body Mass Index (BMI) was measured at baseline and categorised as normal, 18.5-25 kg/m(2); overweight, >25 to <30 kg/m(2); and obese, >= 30 kg/m(2). We analysed the biomarkers high-sensitivity C reactive protein (hs-CRP), interleukin 6 (IL-6), growth differentiation factor-15 (GDF-15), troponin T and N-terminal B-type natriuretic peptide (NT-pro-BNP). Outcomes included stroke/systemic embolism (SE), myocardial infarction (MI), composite (stroke/SE, MI, or all-cause mortality), all-cause and cardiac mortality, and major bleeding.ResultsCompared with normal BMI, obese patients had significantly higher levels of hs-CRP and IL-6 and lower levels of GDF-15, troponin T and NT-pro-BNP. In multivariable analyses, higher compared with normal BMI was associated with a lower risk of all-cause mortality (overweight: HR 0.73 (95% CI 0.63 to 0.86); obese: 0.67 (0.56 to 0.80), p<0.0001), cardiac death (overweight: HR 0.74 (95% CI 0.60 to 0.93); obese: 0.71 (0.56 to 0.92), p=0.01) and composite endpoint (overweight: 0.80 (0.70 to 0.92); obese: 0.72 (0.62 to 0.84), p<0.0001).ConclusionsRegardless of biomarkers indicating inflammation or cardiac or renal dysfunction, obesity was independently associated with an improved survival in anticoagulated patients with AF.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
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- ref (subject category)
- art (subject category)
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Open heart
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- By the author/editor
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Sandhu, Roopinde ...
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Ezekowitz, Justi ...
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Hijazi, Ziad
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Westerbergh, Joh ...
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Aulin, Julia
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Alexander, John ...
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Granger, Christo ...
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Halvorsen, Sigru ...
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Hanna, Michael S ...
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Lopes, Renato D.
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Siegbahn, Agneta ...
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Wallentin, Lars, ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Open heart
- By the university
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Uppsala University