Atrial fibrillation and obesity—results of a meta-analysis
Received 3 August 2007; accepted 1 October 2007. published online 10 December 2007.
Background
Obesity has been shown to be associated with atrial enlargement and ventricular diastolic dysfunction, both of which are risk factors for atrial fibrillation (AF). However, the role of obesity as a risk factor for the development of AF is unknown. The study aims to evaluate the role of obesity as a risk factor for the development of AF.
Methods
The MEDLINE/ PUBMED and Cochrane databases were searched for studies in human subjects published in English language between 1966 and May 2007. Studies were included in our analyses if they were population-based cohort or postcardiac surgery cohort and investigated the incidence of AF in relation to the body mass index (BMI) categories.
Results
Of the 468 articles identified, 16 studies that enrolled a total of 123249 individuals met the inclusion criteria. These 16 articles included 5 population-based cohort studies that enrolled 78602 adult individuals from the United States and 3 European countries and 11 postcardiac surgery studies that enrolled 44647 patients.
Based on the population-based cohort studies, obese individuals have an associated 49% increased risk of developing AF compared to nonobese individuals (relative risk 1.49, 95% CI 1.36-1.64). The risk of AF increased in parallel with greater BMI in this cohort. In contrast, in the postcardiac surgery studies, obese individuals do not have an associated increased risk of developing AF compared to nonobese individuals (relative risk 1.02, 95% CI 0.99-1.06).
Conclusions
Our findings demonstrate that obesity increased the risk of developing AF by 49% in the general population, and the risk escalated in parallel with increased BMI. Thus, AF evolves as yet another pathogenetic factor by which obesity may increase cardiovascular and cerebrovascular events.
aDivision of Cardiology, Beth Israel Medical Center, New York, NY
bDivision of Cardiology, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY
cDivision of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN
Reprint requests: Franz H. Messerli, MD, FACC, FACP, Hypertension Program, Division of Cardiology, St. Luke's-Roosevelt Hospital, Columbia University College of Physicians and Surgeons, 1000 10th Avenue, Suite 3B-30, New York, NY 10019.
Dr Messerli served as an ad hoc consultant/speaker for the following organizations: Abbott, GSK, Novartis, Pfizer, AstraZeneca, Bayer, Boehringer Ingelheim, BMS, Forest, Sankyo, and Sanofi. Dr Somers is supported by grants HL 73211, HL 65176, and MO1-RR00585 from the National institutes of Health (Bethesda, MD). He serves as a consultant for Respironics, Cardiac Concepts, ResMed, and Sepracor.
This work was presented in part at the 2007 Annual Scientific Session of the American College of Cardiology, New Orleans, LA.
ABSTRACT
249 individuals met the inclusion criteria. These 16 articles included 5 population-based cohort studies that enrolled 78