Overweight, obesity and incident atrial fibrillation: Real‐world evidence from 400 000 patients in Germany
Authors' conclusion
Obesity significantly increases the risk of AF through both comorbidity-related and potentially independent pathways. While nearly one-third of the excess risk may be preventable through the management of cardiometabolic conditions, a notable proportion of the association remains unexplained by these mediators. These findings highlight the need for comprehensive strategies that address both obesity itself and its associated diseases to reduce the burden of AF.
Study context
- Population
- Patients aged ≥40 years with documented body mass index (BMI) in German general practices, 2005–2023
- Participants
- 392,146 patients
- Exposure
- Overweight and obese vs normal weight
- Outcome
- New diagnosis of AF
- Follow-up
- Within 10 years
Methodological detailsDisease Analyzer database (IQVIA), German general practices, multivariable Cox regression, causal mediation analysis
- Disease Analyzer database (IQVIA)
- German general practices
- Multivariable Cox regression
- Causal mediation analysis
Main finding
As reported in the abstract
- Obesity associated with significantly increased atrial fibrillation (AF) risk, HR
- 1.43 (95% CI 1.38-1.48)
Observational data: associations, not effects.
Further findings
Causal mediation analysis: obesity-related AF risk mediated through comorbidities
- Excess total risk
- 106%
- Mediated through comorbidities
- 27%
- Direct effect
- 79%
Proportion of mediated effects in women
- Mediated proportion in women (higher)
- up to 30.1%
Original publication
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