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

ABSTRACT

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/m2 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/m2, 22,0-24,9 kg/m2 (taken as a reference), 25,0-29,9 kg/m2, 30,0-34,9 kg/m2, 35,0-39,9 kg/m2 and 40,0-60,0 kg/m2. 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/m2. Patients aged ≥75 years showed an insignificant trend towards the maximum frequency of IS with a BMI of 18,5-21,9 kg/m2. 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/m2 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/m2 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.