Danielle Dircks BS, Eh Khaing BS, Ahmad Aroudaky MD, Muaaz Almerstani MD, Nmair Alziadin MD, Radha P. Kanneganti MBBS, MPH, James Aguto BS, HCB, HLA, Jmaylia Mimms CMA, NICT, Chen Jiang MD, Lluis Mont MD, Domenico Grieco MD, PhD, Carina Blomstrom-Lundqvist MD, Karapet V. Davtyan MD, PhD, Sandeep Prabhu MD, Peter Kistler MBBS, PhD, FHRS, Arash Aryana MD, PhD, FACC, FHRS, Jason G. Andrade MD, Laurent Macle MD, William Schleifer MD, Jason Payne MD, Arthur Easley MD, Faris Khan MD, John Windle MD, Shane Tsai MD, MBA, Daniel Anderson MD, PhD, Gleb Haynatzki PhD, DSc, Thoetchai Peeraphatdit MD, MS, Niyada Naksuk MD
{"title":"肥胖症在当代心房颤动消融随机对照试验中的代表性。","authors":"Danielle Dircks BS, Eh Khaing BS, Ahmad Aroudaky MD, Muaaz Almerstani MD, Nmair Alziadin MD, Radha P. Kanneganti MBBS, MPH, James Aguto BS, HCB, HLA, Jmaylia Mimms CMA, NICT, Chen Jiang MD, Lluis Mont MD, Domenico Grieco MD, PhD, Carina Blomstrom-Lundqvist MD, Karapet V. Davtyan MD, PhD, Sandeep Prabhu MD, Peter Kistler MBBS, PhD, FHRS, Arash Aryana MD, PhD, FACC, FHRS, Jason G. Andrade MD, Laurent Macle MD, William Schleifer MD, Jason Payne MD, Arthur Easley MD, Faris Khan MD, John Windle MD, Shane Tsai MD, MBA, Daniel Anderson MD, PhD, Gleb Haynatzki PhD, DSc, Thoetchai Peeraphatdit MD, MS, Niyada Naksuk MD","doi":"10.1111/jce.16396","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The prevalence and impact of obesity on outcomes of atrial fibrillation (AF) ablation randomized controlled trials (RCTs) have not been well studied.</p>\n </section>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>To examine the proportion of participants with obesity enrolled in RCTs of AF ablation and outcomes of ablation when subgroup analysis of participants with obesity were available.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We systematically searched PubMed and EMBASE for AF ablation RCTs published between January 1, 2015 to May 31, 2022. When body mass index (BMI) data were available, normal distribution was assumed and a <i>z</i> score was used to estimate the proportion of obesity. Results categorized by BMI or body weight status were reviewed. Authors were contacted for additional information.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of 148 eligible RCTs with 30174 participants, 144 (97.30%) RCTs did not report the proportion of participants with obesity, while published information regarding BMI was available in 63.51%. Three trials excluded patients based on BMI. Using reported BMI, we estimated the proportion of participants with obesity varied greatly across these trials, ranging from 5.82%–71.9% (median 38.02%, interquartile 29.64%, 49.10%). Patients with obesity were represented in a greater proportion among trials conducted in North America (50.23%) and Asia (44.72%), compared to others (32.16%), <i>p</i> < .001. Subgroup analysis or analysis adjusting for BMI was reported in only 13 (8.78%) RCTs; four (30.77%) of these suggested that BMI or body weight might negatively affect primary outcomes.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Obesity is a common comorbidity among AF patients. However, most AF ablation RCTs underreported the proportion of participants with obesity and its impact on the primary outcomes.</p>\n </section>\n </div>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.16396","citationCount":"0","resultStr":"{\"title\":\"Representation of obesity in contemporary atrial fibrillation ablation randomized controlled trials\",\"authors\":\"Danielle Dircks BS, Eh Khaing BS, Ahmad Aroudaky MD, Muaaz Almerstani MD, Nmair Alziadin MD, Radha P. Kanneganti MBBS, MPH, James Aguto BS, HCB, HLA, Jmaylia Mimms CMA, NICT, Chen Jiang MD, Lluis Mont MD, Domenico Grieco MD, PhD, Carina Blomstrom-Lundqvist MD, Karapet V. Davtyan MD, PhD, Sandeep Prabhu MD, Peter Kistler MBBS, PhD, FHRS, Arash Aryana MD, PhD, FACC, FHRS, Jason G. Andrade MD, Laurent Macle MD, William Schleifer MD, Jason Payne MD, Arthur Easley MD, Faris Khan MD, John Windle MD, Shane Tsai MD, MBA, Daniel Anderson MD, PhD, Gleb Haynatzki PhD, DSc, Thoetchai Peeraphatdit MD, MS, Niyada Naksuk MD\",\"doi\":\"10.1111/jce.16396\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>The prevalence and impact of obesity on outcomes of atrial fibrillation (AF) ablation randomized controlled trials (RCTs) have not been well studied.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>To examine the proportion of participants with obesity enrolled in RCTs of AF ablation and outcomes of ablation when subgroup analysis of participants with obesity were available.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We systematically searched PubMed and EMBASE for AF ablation RCTs published between January 1, 2015 to May 31, 2022. When body mass index (BMI) data were available, normal distribution was assumed and a <i>z</i> score was used to estimate the proportion of obesity. Results categorized by BMI or body weight status were reviewed. Authors were contacted for additional information.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Of 148 eligible RCTs with 30174 participants, 144 (97.30%) RCTs did not report the proportion of participants with obesity, while published information regarding BMI was available in 63.51%. Three trials excluded patients based on BMI. Using reported BMI, we estimated the proportion of participants with obesity varied greatly across these trials, ranging from 5.82%–71.9% (median 38.02%, interquartile 29.64%, 49.10%). Patients with obesity were represented in a greater proportion among trials conducted in North America (50.23%) and Asia (44.72%), compared to others (32.16%), <i>p</i> < .001. Subgroup analysis or analysis adjusting for BMI was reported in only 13 (8.78%) RCTs; four (30.77%) of these suggested that BMI or body weight might negatively affect primary outcomes.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Obesity is a common comorbidity among AF patients. 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Representation of obesity in contemporary atrial fibrillation ablation randomized controlled trials
Background
The prevalence and impact of obesity on outcomes of atrial fibrillation (AF) ablation randomized controlled trials (RCTs) have not been well studied.
Objective
To examine the proportion of participants with obesity enrolled in RCTs of AF ablation and outcomes of ablation when subgroup analysis of participants with obesity were available.
Methods
We systematically searched PubMed and EMBASE for AF ablation RCTs published between January 1, 2015 to May 31, 2022. When body mass index (BMI) data were available, normal distribution was assumed and a z score was used to estimate the proportion of obesity. Results categorized by BMI or body weight status were reviewed. Authors were contacted for additional information.
Results
Of 148 eligible RCTs with 30174 participants, 144 (97.30%) RCTs did not report the proportion of participants with obesity, while published information regarding BMI was available in 63.51%. Three trials excluded patients based on BMI. Using reported BMI, we estimated the proportion of participants with obesity varied greatly across these trials, ranging from 5.82%–71.9% (median 38.02%, interquartile 29.64%, 49.10%). Patients with obesity were represented in a greater proportion among trials conducted in North America (50.23%) and Asia (44.72%), compared to others (32.16%), p < .001. Subgroup analysis or analysis adjusting for BMI was reported in only 13 (8.78%) RCTs; four (30.77%) of these suggested that BMI or body weight might negatively affect primary outcomes.
Conclusion
Obesity is a common comorbidity among AF patients. However, most AF ablation RCTs underreported the proportion of participants with obesity and its impact on the primary outcomes.
期刊介绍:
Journal of Cardiovascular Electrophysiology (JCE) keeps its readership well informed of the latest developments in the study and management of arrhythmic disorders. Edited by Bradley P. Knight, M.D., and a distinguished international editorial board, JCE is the leading journal devoted to the study of the electrophysiology of the heart.