International Journal of General Medicine (Jun 2022)
Body Mass Index and New-Onset Atrial Fibrillation in Patients with Acute Myocardial Infarction
Abstract
Lei Liu,1 Xiaoyan Liu,1 Xiaosong Ding,1 Hui Chen,1 Hongwei Li1– 3 1Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease, Beijing, People’s Republic of China; 3Department of Geriatrics, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Hongwei Li, Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Beijing, 100050, People’s Republic of China, Tel +8613801396679, Email [email protected]; [email protected]: The “obesity paradox” has not been elucidated in the long-term outcomes in acute myocardial infarction (AMI) patients. This study sought to characterize the relationship between body mass index (BMI) and the risk of new-onset atrial fibrillation (NOAF).Methods: A total of 4282 participants free from AF at baseline were identified at Beijing Friendship Hospital. Baseline body mass index (BMI) was categorized into four groups. Incidence of NOAF was observed at the follow-up visits. The associations between different BMI categories and the incidence of NOAF were assessed by multivariate Cox regression analysis.Results: Over a median follow-up period of 42.0 months, 4282 participants (age 62.7 ± 6.6 years, 38.7% women) were enrolled, 23.0% were BMI < 23.0kg/m2, 22.5% were 23.0– 24.9 kg/m2, 44.3% were 25.0– 29.9 kg/m2 and 10.2% were ≥ 30.0 kg/m2. Compared with patients with the lowest BMI levels, those with BMI≥ 30 kg/m2 showed a younger, higher inflammatory response and a larger left atrium and were more likely to be combined with traditional cardiovascular risk factors. After adjustment for confounding variables, compared to BMI ≥ 30 kg/m2 group, patients with lower BMI (< 23 kg/m2) significantly increased the risk of NOAF in AMI patients (HR 2.884, 95% CI 1.302– 6.392). Moreover, the all-cause mortality and cardiac mortality in BMI < 23.0kg/m2 group was apparently higher than that in BMI≥ 30 kg/m2 group after a long-term follow-up.Conclusion: In this AMI cohort study, the present finding of an inverse association between BMI and risk of NOAF supports the “obesity paradox”. Decreasing BMI was associated with an increased risk of NOAF.Trial Registration: Prospective registered.Keywords: atrial fibrillation, acute myocardial infarction, body mass index, obesity
