title: Effects of body mass index on risks for ischemic stroke, thromboembolism, and mortality in Chinese atrial fibrillation patients: a single-center experience.
abstract: BACKGROUND
  Obesity is considered to be related to recurrence of atrial fibrillation (AF), left atrial thrombus formation, and atrial remodeling. However, whether obesity is an independent risk factor for stroke and other thromboembolic events is still controversial.
  
  
  OBJECTIVE
  This study aimed to investigate the effects of body mass index (BMI) on the risks of stroke, thromboembolism, and mortality in AF patients.
  
  
  METHODS
  Patients who were diagnosed with nonvalvular AF were included in this observational, retrospective study. The study population was stratified by BMI at baseline. The Cox proportional hazard model was adopted to calculate adjusted hazard ratios of risk factors for adverse clinical events (stroke, thromboembolism, and mortality).
  
  
  RESULTS
  A total of 1286 AF patients (males, 78.30%; mean age, 74.50 years; 94.48% paroxysmal AF) were followed up for a median of 2.1 years (IQR: 1.5-2.9 years). Overall, 159 patients died. A total of 84 strokes and 35 thromboembolic events occurred. Multivariate analysis showed that overweight (25.0≤BMI<30.0 kg/m2) and age ≥75 years were independent risk factors for ischemic stroke (both P<0.01). Obesity (BMI ≥30.0 kg/m2), age ≥75 years, persistent/permanent AF, and prior thromboembolism were independent risk factors for thromboembolism (all P<0.05). Underweight (BMI <18.5 kg/m2), age ≥75 years, prior ischemic stroke/transient ischemic attack, renal dysfunction, and heart failure were independent risk factors for all-cause deaths (all P<0.05).
  
  
  CONCLUSIONS
  Overweight or obesity may be a risk factor of ischemic stroke and thromboembolism in AF patients. Excessive low weight is significantly associated with increased all-cause mortality.
authors.affiliation: Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Hai-Jun
authors.initials: HJ
authors.lastname: Wang
authors.affiliation: Healthcare Department 2, Hainan Branch of Chinese PLA General Hospital, Sanya, China.
authors.forename: Quan-Jin
authors.initials: QJ
authors.lastname: Si
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Zhao-Liang
authors.initials: ZL
authors.lastname: Shan
authors.affiliation: Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Yu-Tao
authors.initials: YT
authors.lastname: Guo
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Lin
authors.affiliation: Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Xiao-Ning
authors.initials: XN
authors.lastname: Zhao
authors.affiliation: Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Yu-Tang
authors.initials: YT
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001281:Atrial Fibrillation / Q000150:complications* / Q000401:mortality; D015992:Body Mass Index; D002545:Brain Ischemia / Q000209:etiology* / Q000401:mortality; D002681:China; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013923:Thromboembolism / Q000209:etiology* / Q000401:mortality
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