Faculty of Medical Sciences, Universidade de Pernambuco, Recife, Brazil.
Curr Cardiol Rev. 2022;18(5):8-10. doi: 10.2174/1573403X18666220324111343.
Obesity, a chronic disease established as a global epidemic by the World Health Organization, is considered a risk factor for atrial fibrillation (AF), the most common sustained cardiac arrhythmia, which has high morbidity and mortality. Although both obesity and AF are diseases associated with negative outcomes, studies have shown the presence of an obesity paradox, in which patients with a high body mass index (BMI) and AF have a better prognosis than patients with a normal BMI. Despite the fact that the mechanisms that lead to this paradox are still uncertain, adequate anticoagulation in obese patients seems to play an important role in reducing adverse events in this group. In this perspective article, the authors discuss the relationship between new oral anticoagulants (NOACs), namely, apixaban, edoxaban and rivaroxaban (factor Xa inhibitors) and dabigatran (direct inhibitor of thrombin), and the obesity paradox, seeking to deepen the understanding of the mechanism that leads to this paradox.
肥胖症是一种慢性疾病，世界卫生组织将其确立为全球性流行病，被认为是心房颤动（AF）的一个风险因素，AF 是最常见的持续性心律失常，具有较高的发病率和死亡率。尽管肥胖症和 AF 都是与不良结局相关的疾病，但研究表明存在肥胖悖论，即体重指数（BMI）较高的 AF 患者比 BMI 正常的患者预后更好。尽管导致这种悖论的机制尚不确定，但肥胖患者接受充分的抗凝治疗似乎在降低该人群的不良事件方面发挥着重要作用。在这篇观点文章中，作者讨论了新型口服抗凝剂（NOACs），即阿哌沙班、依度沙班和利伐沙班（Xa 因子抑制剂）以及达比加群（直接凝血酶抑制剂）与肥胖悖论之间的关系，旨在深入了解导致这种悖论的机制。
