{"id":"07f85b1327c7","type":"article","url":"https://hartvaat.nl/2019/05/14/bmi-en-uitkomsten-bij-af-behandeld-met-edoxaban-of-warfarine-engage-af-timi-48/","title":"BMI en uitkomsten bij AF behandeld met edoxaban of warfarine: ENGAGE AF-TIMI 48","title_en":"Relationship between body mass index and outcomes in patients with atrial fibrillation treated with edoxaban or warfarin in the ENGAGE AF-TIMI 48 trial.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":["obesitas"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehy861","source_url":"https://doi.org/10.1093/eurheartj/ehy861","authors":["Giuseppe Boriani","Christian T Ruff","Julia F Kuder","Minggao Shi","Hans J Lanz","Howard Rutman","Michele F Mercuri","Elliott M Antman","Eugene Braunwald","Robert P Giugliano"],"significance":5,"published":"2019-05-14","source_date":"2019-05-14","image":"","kennis":["https://hartvaat.nl/kennis/antistolling/edoxaban/"],"congress":"","summary_en":"This ENGAGE AF-TIMI 48 analysis showed that the relationship between BMI and outcomes in AF is complex, with both underweight and morbid obesity associated with worse prognosis, regardless of edoxaban versus warfarin treatment.","created":"2026-07-03T10:27:55Z","updated":"2026-07-03T13:27:08Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"ENGAGE AF-TIMI 48 analyse naar de relatie tussen BMI en uitkomsten bij AF-patiënten op edoxaban of warfarine.","abstract_original":"AIMS: To investigate the relationship between body mass index (BMI) and outcomes in patients with atrial fibrillation (AF). METHODS AND RESULTS: In the ENGAGE AF-TIMI 48 trial, patients with AF were randomized to warfarin (international normalized ratio 2.0-3.0) or edoxaban. The cohort (N = 21 028) included patients across BMI categories (kg/m2): underweight (<18.5) in 0.8%, normal (18.5 to <25) in 21.4%, overweight (25 to <30) in 37.6%, moderately obese (30 to <35) in 24.8%, severely obese (35 to <40) in 10.0%, and very severely obese (≥40) in 5.5%. In an adjusted analysis, higher BMI (continuous, per 5 kg/m2 increase) was significantly and independently associated with lower risks of stroke/systemic embolic event (SEE) [hazard ratio (HR) 0.88, P = 0.0001], ischaemic stroke/SEE (HR 0.87, P < 0.0001), and death (HR 0.91, P < 0.0001), but with increased risks of major (HR 1.06, P = 0.025) and major or clinically relevant non-major bleeding (HR 1.05, P = 0.0007). There was a significant interaction between sex and increasing BMI category, with lower risk of ischaemic stroke/SEE in males and increased risk of bleeding in women. Trough edoxaban concentration and anti-Factor Xa activity were similar across BMI groups >18.5 kg/m2, while time in therapeutic range for warfarin improved significantly as BMI increased (P < 0.0001). The effects of edoxaban vs. warfarin on stroke/SEE, major bleeding, and net clinical outcome were similar across BMI groups. CONCLUSION: An increased BMI was independently associated with a lower risk of stroke/SEE, better survival, but increased risk of bleeding. The efficacy and safety profiles of edoxaban were similar across BMI categories ranging from 18.5 to >40."}