High Fitness Might be Associated with the Development of New-Onset Atrial Fibrillation in Obese Non-Athlethic Adults
키워드
요약
Background: Data on the association between AF and fitness is conflicting.
Objectives: The aim of this analysis was to investigate the association between fitness, obesity and incidence of atrial fibrillation (AF) among apparently healthy non-athlete adults.
Methods: We investigated 20,410 self-referred subjects who were annually screened in a tertiary medical center. All subjects were free of AF and completed maximal exercise stress test according to the Bruce protocol at baseline. Fitness was categorized into age- and sex-specific quintiles (Q) according to treadmill time. Subjects were categorized to low (Q1-Q2) and high fitness (Q3-5) groups. The primary end point was new-onset AF during follow-up.
Results: Mean age was 48 ± 10 years, and 72% were men. A total of 463 (2.3%) events occurred during an average follow-up of 8 ± 5 years corresponding to an AF event rate of 0.3% per person year. Univariate and multivariate models showed that AF risk was similar in both fitness groups. However, AF event rate was 0.55% per person year among high fitness obese subjects, compared with 0.31% for low fitness obese subjects (p<0.01). Subgroup interaction analysis showed that AF risk is obesity-dependent, such that in the obese group (>= 30 kg/m2) high fitness was independently associated with a significant 79% increased AF risk (95% CI 1.15-2.78; p=0.01), whereas among non-obese subjects the rate of events was similar between both fitness groups (p for interaction = (1)).
Conclusions: Our findings suggest that high fitness might be associated with increased AF risk among obese subjects.
Keywords: Atrial Fibrillation AF; Exercise Stress Test; Fitness; Obesity; Obesity Paradox.
