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Impact of body mass index on real-world outcomes of rivaroxaban treatment in Japanese patients with non-valvular atrial fibrillation
This sub-analysis of the XAPASS, a prospective, single-arm, observational study, aimed to evaluate relationships between body mass index (BMI) and safety (major bleeding and all-cause mortality) and effectiveness [stroke/non-central nervous system (non-CNS) systemic embolism (SE)/myocardial infarcti...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Japan
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7332477/ https://www.ncbi.nlm.nih.gov/pubmed/32253531 http://dx.doi.org/10.1007/s00380-020-01587-z |
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author | Murakawa, Yuji Ikeda, Takanori Ogawa, Satoshi Kitazono, Takanari Nakagawara, Jyoji Minematsu, Kazuo Miyamoto, Susumu Hayashi, Yasuhiro Kidani, Yoko Okayama, Yutaka Sunaya, Toshiyuki Sato, Shoichiro Yamanaka, Satoshi |
author_facet | Murakawa, Yuji Ikeda, Takanori Ogawa, Satoshi Kitazono, Takanari Nakagawara, Jyoji Minematsu, Kazuo Miyamoto, Susumu Hayashi, Yasuhiro Kidani, Yoko Okayama, Yutaka Sunaya, Toshiyuki Sato, Shoichiro Yamanaka, Satoshi |
author_sort | Murakawa, Yuji |
collection | PubMed |
description | This sub-analysis of the XAPASS, a prospective, single-arm, observational study, aimed to evaluate relationships between body mass index (BMI) and safety (major bleeding and all-cause mortality) and effectiveness [stroke/non-central nervous system (non-CNS) systemic embolism (SE)/myocardial infarction (MI)] outcomes in Japanese patients with non-valvular atrial fibrillation (NVAF) receiving rivaroxaban. Patients were categorized according to BMI (kg/m(2)) as underweight (< 18.5), normal weight (18.5 to < 25), overweight (25 to < 30), or obese (≥ 30). In total, 9578 patients with NVAF completed the 1-year follow-up and were evaluated; of these, 7618 patients had baseline BMI data. Overall, 542 (5.7%), 4410 (46.0%), 2167 (22.6%), and 499 (5.2%) patients were underweight, normal weight, overweight, and obese, respectively. Multivariable Cox regression analysis demonstrated that none of the BMI categories were independent predictors of major bleeding whereas being underweight was independently associated with increased all-cause mortality [hazard ratio (HR) 3.56, 95% confidence interval (CI) 2.40–5.26, p < 0.001]. The incidence of stroke/non-CNS SE/MI was higher in patients who were underweight than in those of normal weight (HR 2.11, 95% CI 1.20–3.70, p = 0.009). However, in multivariable analyses, being underweight was not identified as an independent predictor of stroke/non-CNS SE/MI (HR 1.64, 95% CI 0.90–2.99, p = 0.104). In conclusion, the high incidence of thromboembolic events and all-cause mortality in patients who were underweight highlights that thorough evaluation of disease status and comorbidities may be required in this population. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00380-020-01587-z) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-7332477 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Japan |
record_format | MEDLINE/PubMed |
spelling | pubmed-73324772020-07-07 Impact of body mass index on real-world outcomes of rivaroxaban treatment in Japanese patients with non-valvular atrial fibrillation Murakawa, Yuji Ikeda, Takanori Ogawa, Satoshi Kitazono, Takanari Nakagawara, Jyoji Minematsu, Kazuo Miyamoto, Susumu Hayashi, Yasuhiro Kidani, Yoko Okayama, Yutaka Sunaya, Toshiyuki Sato, Shoichiro Yamanaka, Satoshi Heart Vessels Original Article This sub-analysis of the XAPASS, a prospective, single-arm, observational study, aimed to evaluate relationships between body mass index (BMI) and safety (major bleeding and all-cause mortality) and effectiveness [stroke/non-central nervous system (non-CNS) systemic embolism (SE)/myocardial infarction (MI)] outcomes in Japanese patients with non-valvular atrial fibrillation (NVAF) receiving rivaroxaban. Patients were categorized according to BMI (kg/m(2)) as underweight (< 18.5), normal weight (18.5 to < 25), overweight (25 to < 30), or obese (≥ 30). In total, 9578 patients with NVAF completed the 1-year follow-up and were evaluated; of these, 7618 patients had baseline BMI data. Overall, 542 (5.7%), 4410 (46.0%), 2167 (22.6%), and 499 (5.2%) patients were underweight, normal weight, overweight, and obese, respectively. Multivariable Cox regression analysis demonstrated that none of the BMI categories were independent predictors of major bleeding whereas being underweight was independently associated with increased all-cause mortality [hazard ratio (HR) 3.56, 95% confidence interval (CI) 2.40–5.26, p < 0.001]. The incidence of stroke/non-CNS SE/MI was higher in patients who were underweight than in those of normal weight (HR 2.11, 95% CI 1.20–3.70, p = 0.009). However, in multivariable analyses, being underweight was not identified as an independent predictor of stroke/non-CNS SE/MI (HR 1.64, 95% CI 0.90–2.99, p = 0.104). In conclusion, the high incidence of thromboembolic events and all-cause mortality in patients who were underweight highlights that thorough evaluation of disease status and comorbidities may be required in this population. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00380-020-01587-z) contains supplementary material, which is available to authorized users. Springer Japan 2020-04-06 2020 /pmc/articles/PMC7332477/ /pubmed/32253531 http://dx.doi.org/10.1007/s00380-020-01587-z Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Article Murakawa, Yuji Ikeda, Takanori Ogawa, Satoshi Kitazono, Takanari Nakagawara, Jyoji Minematsu, Kazuo Miyamoto, Susumu Hayashi, Yasuhiro Kidani, Yoko Okayama, Yutaka Sunaya, Toshiyuki Sato, Shoichiro Yamanaka, Satoshi Impact of body mass index on real-world outcomes of rivaroxaban treatment in Japanese patients with non-valvular atrial fibrillation |
title | Impact of body mass index on real-world outcomes of rivaroxaban treatment in Japanese patients with non-valvular atrial fibrillation |
title_full | Impact of body mass index on real-world outcomes of rivaroxaban treatment in Japanese patients with non-valvular atrial fibrillation |
title_fullStr | Impact of body mass index on real-world outcomes of rivaroxaban treatment in Japanese patients with non-valvular atrial fibrillation |
title_full_unstemmed | Impact of body mass index on real-world outcomes of rivaroxaban treatment in Japanese patients with non-valvular atrial fibrillation |
title_short | Impact of body mass index on real-world outcomes of rivaroxaban treatment in Japanese patients with non-valvular atrial fibrillation |
title_sort | impact of body mass index on real-world outcomes of rivaroxaban treatment in japanese patients with non-valvular atrial fibrillation |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7332477/ https://www.ncbi.nlm.nih.gov/pubmed/32253531 http://dx.doi.org/10.1007/s00380-020-01587-z |
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