Presentation on theme: "Www.tri-london.ac.uk The GARFIELD Registry is funded by an unrestricted research grant from Bayer Pharma AG Lessons Beyond Atrial Fibrillation: Focus on."— Presentation transcript:
www.tri-london.ac.uk The GARFIELD Registry is funded by an unrestricted research grant from Bayer Pharma AG Lessons Beyond Atrial Fibrillation: Focus on Obesity Samuel Z. Goldhaber, MD Director, Thrombosis Research Group Cardiovascular Division Brigham and Women’s Hospital Professor of Medicine Harvard Medical School
Disclosures Research Support: BMS; BTG; Daiichi; NHLBI; Thrombosis Research Institute Consultant: Ariad; Bayer; Boehringer-Ingelheim; BMS; Daiichi; Janssen, Merck; Pfizer; Portola
Stroke Prevention in AF – Obesity, a Risk Factor beyond CHA 2 DS 2 -VASc – Obesity’s global burden of disease Diet and exercise can reduce AF symptoms and severity (as well as waist circumference and BMI) Stroke, venous thromboembolism, and MI share common risk factors, such as obesity GARFIELD-AF: will improve our understanding of obesity-AF connection Learning Objectives
History/Neuro Exam 76 y.o. man with hypertension, hyperlipidemia, obesity awakens with garbled speech, nonsense words, confusion. Wife summons Emergency Services. BP 185/82 mm Hg; HR 129 irreg irreg; 1.7 meters; 117 kg; BMI=38 kg/m 2 Unable to name months, a pen, a watch, or follow command to show thumb
Global Burden of Obesity 3.4 million deaths per year Accounts for 4% of years of life lost Physical inactivity and carbohydrate-heavy eating patterns are considered causal The rise in obesity rates is soaring in economically developing countries and is slowing down in developed countries Prevalence is increasing in children, as well as adults Ng M, et al. Lancet. 2014; epubl May 29. doi:10.1016/S0140-6736(14)60560-8.
Overweight and Obesity 1980 2000 1990 2013 38% Ng M, et al. Lancet. 2014; epubl May 29. doi:10.1016/S0140-6736(14)60560-8.
Take Home Messages 1.Obesity is a risk factor for developing AF, as well as VTE and MI. 2.Obesity may be a risk factor for stroke in patients with established AF. 3.AF patients should embrace a heart-healthy life style: achieve a BMI < 25 to decrease AF symptom burden and severity. 4.GARFIELD-AF will enlighten obesity-stroke relationship in AF: large sample size, adequate power, pertinent CRF.