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Body Mass Index and Adverse Outcomes in Elderly Patients With Atrial Fibrillation : The AMADEUS Trial . BACKGROUND AND PURPOSE Obesity has been associated with increased cardiovascular risk in atrial fibrillation , but little is known in elderly patients with atrial fibrillation . METHODS Post hoc analysis of data from the AMADEUS ( Evaluating the Use of SR34006 Compared to Warfarin or Acenocoumarol in Patients With Atrial Fibrillation ) trial . RESULTS We studied 1588 elderly patients , who were categorized as normal body mass index ( BMI , 18.5-25 kg/m ( 2 ) ; n=515 [ 32.4 % ] ) , overweight ( BMI , 25-30 kg/m ( 2 ) ; n=711 [ 44.8 % ] ) , and obese ( BMI≥30 kg/m ( 2 ) ; n=362 [ 22.8 % ] ) . There was a significant reduction in the composite outcome of cardiovascular death and stroke/systemic embolism with increasing BMI category , being 5.0 % , 3.2 % , and 1.5 % per 100 patient-years , respectively ( P for trend=0.01 ) . Cox proportional hazards analysis found obesity to be associated with a lower risk of the primary composite outcome ( hazard ratio , 0.29 ; 95 % confidence interval , 0.11-0.77 ; P=0.01 ) . In the warfarin arm ( n=814 ) , multivariate logistic regression analysis demonstrated that obesity was independently related to higher odds of time in therapeutic range ≥60 % ( odds ratio , 1.84 ; 95 % confidence interval , 1.21-2.80 ; P=0.004 ) . CONCLUSION Obesity was associated with a lower stroke and mortality rate in elderly anticoagulated atrial fibrillation patients . Obesity was related to good quality anticoagulation control .
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Intervention_Pharmacological
Warfarin
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Intervention_Pharmacological
Acenocoumarol
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Outcome_Mortality
cardiovascular death
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Outcome_Physical
stroke/systemic embolism
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Outcome_Physical
lower stroke
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Outcome_Mortality
mortality rate
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Participant_Age
Elderly
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Participant_Condition
Atrial Fibrillation
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Participant_Age
elderly
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Participant_Condition
atrial fibrillation
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Participant_Condition
Atrial Fibrillation
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Participant_Sample-size
1588
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Participant_Age
elderly
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Participant_Sample-size
n=515
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Participant_Sample-size
n=711
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Participant_Age
elderly
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Participant_Condition
anticoagulated atrial fibrillation