For a long time, overweight has been linked to atrial fibrillation (AF) and atrial flutter (AFL). However, there are limited data regarding obesity’s impact on healthcare resource utilization among patients with AF/AFL. In a retrospective study published in American Heart Journal Plus: Cardiology Research and Practice, Jonathan Norton and colleagues evaluated the connection between obesity and health – care resource requirements in people with AF/AFL.
Using the MarketScan claims database and ICD-10 codes, the researchers identified patients who were newly diagnosed with AF/ AFL in 2017 and 2018 and classified them according to obesity status. Patients were followed for two years, at which point all data was censored. Norton and colleagues used Cox proportional hazards regression models to assess the adjusted hazard ratio (aHR) for patients with versus without obesity.
There were 55,271 newly diagnosed patients, including 43,314 (78.4%) without obesity and 11,957 (21.6%) with obesity. Men comprised most of the patients in both the non-obese (65.3% vs 34.7%) and obese (62.4% vs 37.7%) groups. The average age (SD) of patients also was similar between the non-obese (54.5 ± 9.7) and obese (54.7 ± 8.4) groups.
Compared with patients without obesity, those with obesity had significantly higher rates of heart failure (3.2% vs 2.2%, P<0.001), hypertension (53.7% vs 38.7%, P<0.001), diabetes (21.6% vs 14.5%, P<0.001), and vascular disease (12.9% vs 10.6%, P<0.001). The group with obesity also experienced more TIA/CVA events (3.0% vs 2.5%, P=0.001).
In addition, patients with obesity had a significantly higher incidence of emergency department visits (6.5% vs 4.0%), hospitalizations (10.7% vs 5.5%), cardioversions (12.7% vs 6.6%), and ablation procedures (8.6% vs 5.3%).
“Obese individuals had significantly higher risk of hospitalizations (aHR, 1.86; 95% CI, 1.74-1.99), cardioversions (aHR, 2.00; 95% CI, 1.86-2.13), ablation procedures (aHR, 1.62; 95% CI, 1.50-1.74), and emer – gency department visits (aHR, 1.60; 95% CI, 1.47-1.74) compared to the non-obese cohort. No significant association was found for [transesophageal echocardiogram], which could be due to a smaller sample size, (aHR 1.39; 95% CI, 0.73-2.67),” the investigators wrote.
Norton and colleagues concluded that newly diagnosed patients with AF/AFL who have obesity tend to utilize more healthcare resources than those without.