Absence of Obesity Paradox in All-Cause Mortality Among Chinese Patients With an Implantable Cardioverter Defibrillator: A Multicenter Cohort Study

Background: The results of studies on the obesity paradox in all-cause mortality are inconsistent in patients equipped with an implantable cardioverter-defibrillator (ICD). There is a lack of relevant studies on Chinese populations with large sample size. This study aimed to investigate whether the...

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Autores principales:	Bin Zhou, Xuerong Sun, Na Yu, Shuang Zhao, Keping Chen, Wei Hua, Yangang Su, Jiefu Yang, Zhaoguang Liang, Wei Xu, Min Tang, Shu Zhang
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	obesity paradox body mass index all-cause mortality implantable cardioverter-defibrillator Chinese Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/6992204d6c6e40cf89912b401fca3c00
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spelling	oai:doaj.org-article:6992204d6c6e40cf89912b401fca3c002021-12-03T05:04:15ZAbsence of Obesity Paradox in All-Cause Mortality Among Chinese Patients With an Implantable Cardioverter Defibrillator: A Multicenter Cohort Study2297-055X10.3389/fcvm.2021.730368https://doaj.org/article/6992204d6c6e40cf89912b401fca3c002021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.730368/fullhttps://doaj.org/toc/2297-055XBackground: The results of studies on the obesity paradox in all-cause mortality are inconsistent in patients equipped with an implantable cardioverter-defibrillator (ICD). There is a lack of relevant studies on Chinese populations with large sample size. This study aimed to investigate whether the obesity paradox in all-cause mortality is present among the Chinese population with an ICD.Methods: We conducted a retrospective analysis of multicenter data from the Study of Home Monitoring System Safety and Efficacy in Cardiac Implantable Electronic Device–implanted Patients (SUMMIT) registry in China. The outcome was all-cause mortality. The Kaplan–Meier curves, Cox proportional hazards models, and smooth curve fitting were used to investigate the association between body mass index (BMI) and all-cause mortality.Results: After inclusion and exclusion criteria, 970 patients with an ICD were enrolled. After a median follow-up of 5 years (interquartile, 4.1–6.0 years), in 213 (22.0%) patients occurred all-cause mortality. According to the Kaplan–Meier curves and multivariate Cox proportional hazards models, BMI had no significant impact on all-cause mortality, whether as a continuous variable or a categorical variable classified by various BMI categorization criteria. The fully adjusted smoothed curve fit showed a linear relationship between BMI and all-cause mortality (p-value of 0.14 for the non-linearity test), with the curve showing no statistically significant association between BMI and all-cause mortality [per 1 kg/m2 increase in BMI, hazard ratio (HR) 0.97, 95% CI 0.93–1.02, p = 0.2644].Conclusions: The obesity paradox in all-cause mortality was absent in the Chinese patients with an ICD. Prospective studies are needed to further explore this phenomenon.Bin ZhouBin ZhouXuerong SunNa YuShuang ZhaoKeping ChenWei HuaYangang SuJiefu YangZhaoguang LiangWei XuMin TangShu ZhangFrontiers Media S.A.articleobesity paradoxbody mass indexall-cause mortalityimplantable cardioverter-defibrillatorChineseDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	obesity paradox body mass index all-cause mortality implantable cardioverter-defibrillator Chinese Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	obesity paradox body mass index all-cause mortality implantable cardioverter-defibrillator Chinese Diseases of the circulatory (Cardiovascular) system RC666-701 Bin Zhou Bin Zhou Xuerong Sun Na Yu Shuang Zhao Keping Chen Wei Hua Yangang Su Jiefu Yang Zhaoguang Liang Wei Xu Min Tang Shu Zhang Absence of Obesity Paradox in All-Cause Mortality Among Chinese Patients With an Implantable Cardioverter Defibrillator: A Multicenter Cohort Study
description	Background: The results of studies on the obesity paradox in all-cause mortality are inconsistent in patients equipped with an implantable cardioverter-defibrillator (ICD). There is a lack of relevant studies on Chinese populations with large sample size. This study aimed to investigate whether the obesity paradox in all-cause mortality is present among the Chinese population with an ICD.Methods: We conducted a retrospective analysis of multicenter data from the Study of Home Monitoring System Safety and Efficacy in Cardiac Implantable Electronic Device–implanted Patients (SUMMIT) registry in China. The outcome was all-cause mortality. The Kaplan–Meier curves, Cox proportional hazards models, and smooth curve fitting were used to investigate the association between body mass index (BMI) and all-cause mortality.Results: After inclusion and exclusion criteria, 970 patients with an ICD were enrolled. After a median follow-up of 5 years (interquartile, 4.1–6.0 years), in 213 (22.0%) patients occurred all-cause mortality. According to the Kaplan–Meier curves and multivariate Cox proportional hazards models, BMI had no significant impact on all-cause mortality, whether as a continuous variable or a categorical variable classified by various BMI categorization criteria. The fully adjusted smoothed curve fit showed a linear relationship between BMI and all-cause mortality (p-value of 0.14 for the non-linearity test), with the curve showing no statistically significant association between BMI and all-cause mortality [per 1 kg/m2 increase in BMI, hazard ratio (HR) 0.97, 95% CI 0.93–1.02, p = 0.2644].Conclusions: The obesity paradox in all-cause mortality was absent in the Chinese patients with an ICD. Prospective studies are needed to further explore this phenomenon.
format	article
author	Bin Zhou Bin Zhou Xuerong Sun Na Yu Shuang Zhao Keping Chen Wei Hua Yangang Su Jiefu Yang Zhaoguang Liang Wei Xu Min Tang Shu Zhang
author_facet	Bin Zhou Bin Zhou Xuerong Sun Na Yu Shuang Zhao Keping Chen Wei Hua Yangang Su Jiefu Yang Zhaoguang Liang Wei Xu Min Tang Shu Zhang
author_sort	Bin Zhou
title	Absence of Obesity Paradox in All-Cause Mortality Among Chinese Patients With an Implantable Cardioverter Defibrillator: A Multicenter Cohort Study
title_short	Absence of Obesity Paradox in All-Cause Mortality Among Chinese Patients With an Implantable Cardioverter Defibrillator: A Multicenter Cohort Study
title_full	Absence of Obesity Paradox in All-Cause Mortality Among Chinese Patients With an Implantable Cardioverter Defibrillator: A Multicenter Cohort Study
title_fullStr	Absence of Obesity Paradox in All-Cause Mortality Among Chinese Patients With an Implantable Cardioverter Defibrillator: A Multicenter Cohort Study
title_full_unstemmed	Absence of Obesity Paradox in All-Cause Mortality Among Chinese Patients With an Implantable Cardioverter Defibrillator: A Multicenter Cohort Study
title_sort	absence of obesity paradox in all-cause mortality among chinese patients with an implantable cardioverter defibrillator: a multicenter cohort study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/6992204d6c6e40cf89912b401fca3c00
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Absence of Obesity Paradox in All-Cause Mortality Among Chinese Patients With an Implantable Cardioverter Defibrillator: A Multicenter Cohort Study

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