title: Exploring The Obesity Paradox In Atrial Fibrillation. AFBAR (Atrial Fibrillation Barbanza Area) Registry Results.
abstract: OBJECTIVE
  Previous studies have described an inverse relationship between obesity and adverse events in a variety of conditions. Our aim was to investigate the relationship between obesity and prognosis in patients with atrial fibrillation.
  
  
  METHODS
  We studied 746 patients who were prospectively included, between January and April 2008, in the AFBAR (Atrial Fibrillation in BARbanza area) registry. Patients were categorized into 3 body mass index groups using baseline measurements: normal (< 25 kg/m2), overweight (25-30 kg/m2), and obese (≥30 kg/m2). Survival free from the composite endpoint hospitalization for cardiovascular causes or all-cause mortality was compared across the 3 body mass index groups. A multivariable Cox proportional hazard regression was also performed to determine the independent effect of obesity as well as overweight, with respect to normal body mass index as a reference category, regarding the study endpoint. Median follow-up time was 36 (28-36) months.
  
  
  RESULTS
  49.3% were obese and 38.2% had overweight. The composite endpoint rate was 70.9%, 67.5%, and 57.6% for obese, overweight, and normal weight patients, respectively (log rank test; p=0.02). An inverse association of obesity with a favorable prognosis persisted even after multivariable adjustment: hazard ratio 0.668; 95% confidence interval 0.449-0.995; p=0.047. Hazard ratio of overweight, however, was 0.741; 95% confidence interval: 0.500-1.098; p=0.096.
  
  
  CONCLUSIONS
  Obesity, defined as a body mass index ≥ 30 kg/m2, is associated with better prognosis in a community-based cohort of patients with atrial fibrillation.
authors.affiliation: Cardiology and Coronary Unit Department. Hospital Clinico Universitario de Santiago de Compostela, Spain.
authors.forename: M Cristina
authors.initials: MC
authors.lastname: González-Cambeiro
authors.affiliation: Cardiology and Coronary Unit Department. Hospital Clinico Universitario de Santiago de Compostela, Spain.
authors.forename: Emad
authors.initials: E
authors.lastname: Abu-Assi
authors.affiliation: Cardiology and Coronary Unit Department. Hospital Clinico Universitario de Santiago de Compostela, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Raposeiras-Roubín
authors.affiliation: Cardiology and Coronary Unit Department. Hospital Clinico Universitario de Santiago de Compostela, Spain.
authors.forename: Moisés
authors.initials: M
authors.lastname: Rodríguez-Mañero
authors.affiliation: Xestión sanitaria. Servizo galego de saúde. Santiago de Compostela, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Otero-Raviña
authors.affiliation: Cardiology and Coronary Unit Department. Hospital Clinico Universitario de Santiago de Compostela, Spain.
authors.forename: José
authors.initials: J
authors.lastname: R González-Juanatey
authors.affiliation: Atención primaria, Centro de saúde de Pobra do Caramiñal, Spain.
authors.forename: Genaro
authors.initials: G
authors.lastname: Gutiérrez-Fernández
authors.affiliation: Atención primaria, Centro de saúde de Santiago de Compostela, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Liñares-Stolle
authors.affiliation: Atención primaria, Centro de saúde de Noia, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Alvear-García
authors.affiliation: Atención primaria, Centro de saúde de Bertamiráns, Spain.
authors.forename: Mª Jesús
authors.initials: MJ
authors.lastname: Eirís-Cambre
authors.affiliation: Atención primaria, Centro de saúde de Ribeira, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Cerqueiras-Alcalde
authors.affiliation: Atención primaria, Centro de saúde de Noia, Spain.
authors.forename: Mª José
authors.initials: MJ
authors.lastname: Vázquez López
authors.affiliation: Atención primaria, Centro de saúde de Outes, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Lado-Llerena
keywords: Atrial fibrillation; Body Mass Index; Mortality; Prognosis