Retrospective analysis of the prevalence of ischemic stroke and the appointment of anticoagulant therapy in patients with atrial fibrillation depending on the body mass index

• Published in: Rossiĭskiĭ kardiologicheskiĭ zhurnal Vol. 28; no. 5; p. 5359
• Main Authors: Druzhilov, M. A., Kuznetsova, T. Yu, Druzhilova, O. Yu, Tsarkova, M. K., Gavrilov, D. V., Gusev, A. V.
• Format: Journal Article
• Language: English; Russian
• Published: FIRMA «SILICEA» LLC 01-06-2023
• Subjects: anticoagulant therapy; atrial fibrillation; body mass index; ischemic stroke; obesity
• ISSN: 1560-4071; 2618-7620
• DOI: 10.15829/1560-4071-2023-5359

Aim
. To estimate the prevalence of ischemic stroke (IS) and the appointment of anticoagulant therapy in patients with atrial fibrillation (AF) depending on body mass index (BMI) as part of a retrospective analysis of big data from certain subjects of the Russian Federation using artificial intelligence technologies.
Material and methods
. The information was obtained from the Webiomed predictive analytics platform, which includes depersonalized data from electronic health records of patients in 6 Russian constituent, extracted using artificial intelligence technologies. Individuals with AF aged ≥18 years were selected with available data on BMI of 18,5-60,0 kg/m
2
 inclusive (n=56003; men, 41,0%; age, 67,4±14,5 years, CHA2DS2-VASc score, 3,4±1,8). The following BMI ranges were identified: 18,5-21,9 kg/m
2
, 22,0-24,9 kg/m
2
 (taken as a reference), 25,0-29,9 kg/m
2
, 30,0-34,9 kg/m
2
, 35,0-39,9 kg/m
2
 and 40,0-60,0 kg/m
2
. The indicators were analyzed in age ranges (≤64 years, 65-74 years, ≥75 years) separately among men and women.
Results
. Among men ≤64 years of age, patients with overweight and class 2 obesity were characterized by a significantly higher incidence of IS. Among women ≤64 years, a significantly higher frequency of IS was found in subgroups with overweight and class 1-3 obesity, while among women aged 65-74 years — in a subgroup with a BMI of 18,5-21,9 kg/m
2
. Patients aged ≥75 years showed an insignificant trend towards the maximum frequency of IS with a BMI of 18,5-21,9 kg/m
2
. A higher frequency of anticoagulant therapy prescription was found in subgroups with overweight and class 1-3 obesity; in most age and sex subgroups, the differences are significant. A significantly lower frequency of anticoagulant therapy prescription to persons ≥75 years of age with a BMI of 18,5-21,9 kg/m
2
 was noted.
Conclusion
. The study showed a significant BMI paradox in the context of the relationship between the frequency of IS and BMI value in patients with AF. A higher incidence of IS in persons ≤64 years of age with a BMI ≥25 kg/m
2
 compared with pa­tients with normal weight may be an additional argument for establishing an inde­pen­-dent prognostic role of obesity in the development of thromboembolic events in AF.