Impact of weight/BMI on clinical and bleeding events in 26 805 atrial fibrillation patients on edoxaban from the Global ETNA-AF Registry.

Authors

Giuseppe Boriani, Paulus Kirchhof, José Antonio Gordillo de Souza, Jan Steffel, Yukihiro Koretsune, Tze-Fan Chao, Thomas Weiss, Liliana Zaremba-Pechmann, Johanna van Zyl, Martin Unverdorben, Raffaele De Caterina

Published in

European journal of preventive cardiology. Oct 25, 2025. Epub Oct 25, 2025.

Abstract

Body weight and body mass index (BMI) influence anticoagulation management in atrial fibrillation (AF) in interaction with age/comorbidities.
The Global ETNA-AF programme collected data on AF patients receiving edoxaban in Europe and Asia. The relationship between body weight/BMI (as categorical and continuous variables) and 2-year clinical/bleeding event rates were analyzed.
In enrolled patients (n = 26 805), body weight was 72.2 ± 18.1 kg, and BMI was 26.4 ± 5.0 kg/m2 (mean ± standard deviation). Patients weighing ≤60 kg had the highest annualized rates of stroke/systemic embolic events (SEEs), death and bleeding. Patients >100 kg had the lowest bleeding and stroke/SEE event rates. Patients with BMI <18.5 kg/m2 had the worst adverse events, except for myocardial infarction. Analysis with restricted cubic splines showed relationships between body weight/BMI, and risk, were clearly U-shaped for cardiovascular (CV) and all-cause death. Specific cut-offs for higher risk were identified (Any stroke/SEE: BMI ≤20 kg/m2; haemorrhagic stroke: BMI ≤20 kg/m2, weight ≤53 kg; CV death: BMI ≤22 and ≥32 kg/m2, weight ≤62 kg; all-cause death: BMI ≤24 and ≥30 kg/m2, weight ≤69 kg and ≥118 kg relative to median BMI of 25.7 kg/m2 and median weight of 70 kg). The >60-≤80 kg weight group had the lowest death rate.
In a large cohort of AF patients, U-shaped relationships were found between body weight/BMI and all-cause/CV death at 2-year follow-up. Clinical monitoring of AF patients and associated comorbidities should be intensified at specific thresholds of low body weight and/or low BMI.

PMID:
41137758
Bibliographic data and abstract were imported from PubMed on 25 Oct 2025.

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