Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia.
Binawaluya Cardiac Center, Jakarta, Indonesia.
Eur J Clin Invest. 2021 Jun;51(6):e13499. doi: 10.1111/eci.13499. Epub 2021 Mar 5.
The evidence on the association between obesity and atrial fibrillation (AF) recurrence was equivocal. We aimed to evaluate the dose-response relationship between body mass index (BMI) and AF recurrence and adverse events.
A systematic literature search was conducted using PubMed, Europe PMC, EBSCO, ProQuest and Cochrane Library. Obesity was defined as BMI ≥28 kg/m . The primary outcome was AF recurrence, and the secondary outcome was adverse events. Adverse events were defined as procedure-related complications and cardio-cerebrovascular events.
There were a total of 52,771 patients from 20 studies. Obesity was associated with higher AF recurrence (Odds ratio [OR] 1.30 [95% confidence interval [CI] 1.16-1.47], P < .001; I : 72.7%) and similar rate of adverse events (OR 1.21 [95% CI 0.87-1.67], P = .264; I : 23.9%). Meta-regression showed that the association varies by age (coefficient: -0.03, P = .024). Meta-analysis of highest versus lowest BMI showed that the highest group had higher AF recurrence (OR 1.37 [95% CI 1.18-1.58], P < .001; I : 64.9%) and adverse events (OR 2.02 [95% CI 1.08-3.76], P = .028; I : 49.5%). The linear association analysis for AF recurrence was not significant (P = .544). The dose-response relationship for BMI and AF recurrence was nonlinear (p < 0.001), the curve became steeper at 30-35 kg/m . For adverse events, an increase of 1% for every 1 kg/m increase in BMI (OR 1.01 [95% CI 1.00-1.02], P = .001), the relationship was nonlinear (p = 0.001).
Obesity was associated with higher AF recurrence in patients undergoing catheter ablation. High BMI might be associated with a higher risk for adverse events.
CRD42020198787.
肥胖与心房颤动（AF）复发之间的关联证据尚无定论。我们旨在评估体重指数（BMI）与 AF 复发和不良事件之间的剂量-反应关系。
使用 PubMed、欧洲 PMC、EBSCO、ProQuest 和 Cochrane 图书馆进行系统文献检索。肥胖定义为 BMI≥28 kg/m 。主要结局是 AF 复发，次要结局是不良事件。不良事件定义为与操作相关的并发症和心脑血管事件。
共有来自 20 项研究的 52771 名患者。肥胖与更高的 AF 复发率（比值比[OR]1.30[95%置信区间[CI]1.16-1.47]，P<0.001；I ：72.7%）和相似的不良事件发生率（OR 1.21[95%CI0.87-1.67]，P=0.264；I ：23.9%）相关。荟萃回归表明，这种关联因年龄而异（系数：-0.03，P=0.024）。最高与最低 BMI 的荟萃分析显示，最高组的 AF 复发率更高（OR 1.37[95%CI1.18-1.58]，P<0.001；I ：64.9%）和不良事件（OR 2.02[95%CI1.08-3.76]，P=0.028；I ：49.5%）。AF 复发的线性关联分析不显著（P=0.544）。BMI 与 AF 复发之间的剂量-反应关系是非线性的（p<0.001），在 30-35 kg/m 时曲线变得更陡峭。对于不良事件，BMI 每增加 1%，风险增加 1%（OR 1.01[95%CI1.00-1.02]，P=0.001），关系是非线性的（p=0.001）。
肥胖与接受导管消融治疗的患者的 AF 复发率升高有关。高 BMI 可能与不良事件风险增加有关。
CRD42020198787。
