Department of Cardiovascular Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
Department of Cardiovascular Medicine, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
BMC Cardiovasc Disord. 2020 Jun 5;20(1):270. doi: 10.1186/s12872-020-01544-8.
Underweight or obese status influences the prognosis of atrial fibrillation (AF). However, the association between stratification of body mass index (BMI) and in-hospital outcomes in patients with AF, remains lacking in China.
Using data from the Improving Care for Cardiovascular Disease in China-AF project, which was launched in February 2015 and recruited 150 hospitals in China, we compared characteristics, in-hospital treatments and clinical outcomes among the stratifications of BMI for Asians.
A total of 15,867 AF patients with AF were enrolled, including 830 (5.23%) underweight, 4965 (31.29%) with normal weight, 3716 (23.42%) overweight, 5263 (33.17%) obese class I and 1093 (6.89%) obese class II participants. Compared with normal weight patients, underweight, overweight, and obese patients showed increased percentages of CHADS scores (3-6) and CHADS-VASc scores (5-9). During hospitalization, overweight or obese patients showed greater use of rhythm control medications, anticoagulant drugs, and intervention therapies than underweight-normal weight patients. In adjusted logistic models, BMI was a strong predictor of in-hospital mortality. Especially, underweight BMI was associated with higher incidence of in-hospital mortality, with an adjusted odds ratio of 2.08 (95% confidence interval, 1.56-4.46; p = 0.04) than overweight and obese BMI.
Asian patients with AF and high BMI received more medical treatments and presented less adverse in-hospital outcomes compared with those with underweight-normal weight. Although low BMI may be associated with other comorbidities and advanced age, underweight BMI retained a negative correlation with all-cause mortality in the patients with AF during hospitalization.
体重过轻或肥胖会影响心房颤动（房颤）的预后。然而，在中国，关于 BMI 分层与房颤患者住院结局的相关性研究还较少。
我们利用 2015 年 2 月启动的“改善中国心血管疾病管理-房颤项目”的数据，该项目在中国招募了 150 家医院，比较了亚洲人群 BMI 分层的特征、住院治疗和临床结局。
共纳入 15867 例房颤患者，其中体重过轻 830 例（5.23%），正常体重 4965 例（31.29%），超重 3716 例（23.42%），肥胖 I 级 5263 例（33.17%），肥胖 II 级 1093 例（6.89%）。与正常体重患者相比，体重过轻、超重和肥胖患者的 CHADS 评分（3-6）和 CHADS-VASc 评分（5-9）比例更高。住院期间，超重或肥胖患者比体重正常患者更倾向于使用节律控制药物、抗凝药物和介入治疗。在调整后的逻辑回归模型中，BMI 是住院死亡率的强预测因素。特别是，与超重和肥胖 BMI 相比，体重过轻 BMI 与更高的住院死亡率相关，调整后的比值比为 2.08（95%置信区间，1.56-4.46；P=0.04）。
与体重正常的患者相比，亚洲房颤患者 BMI 较高，接受了更多的治疗，住院期间的不良结局也较少。尽管低 BMI 可能与其他合并症和高龄有关，但在住院期间，低 BMI 仍与房颤患者的全因死亡率呈负相关。
