Patients in the study were given support through a weight loss clinic for a 4-year period. Those who had sustained weight lost and did not let their weight fluctuate were most likely to have arrythmia-free survival.
Maintaining weight loss has many health benefits, and a study presented yesterday at the 64th Annual Meeting of the American College of Cardiology added another item to the list: obese patients with atrial fibrillation who shed pounds are far more likely to rid themselves of this heart ailment.
For obese patients, weight loss might require support, as it did in the LEGACY study, which stands for Long Term Effect of Goal Directed Weight Management on an Atrial Fibrillation Cohort. But if patients lost at least 10% of their body weight, they were 6 times more likely to achieve arrhythmia-free survival.
The study, led by Rajeev Pathak, MD, a cardiologist and fellow in electrophysiology from the University of Adelaide, Australia, said LEGACY was the first to outline the benefits of sustained weight loss, the effects of the amount of weight lost, and the impact of changes in weight over time among patients who suffered from atrial fibrillation (AF), a condition that causes shortness of breath, weakness and can indicate stroke risk. Treatment typically includes anticoagulants, which can present their own risks in some patients.
“We found that sustained weight loss is achievable in obese patients and that it can significantly reduce the burden of atrial fibrillation,” Pathak said. Previous studies, he said, had examined only the short-term effects of weight loss on AF.
Researchers enrolled 355 participants in a weight loss clinic that provided support through 3 in-person visits a month, nutrition guidance, exercise, counseling, and a physical activity diary. All participants were obese (with a BMI of at least 27 kg/m2) and had AF at the start of the study, and all agreed to participate, a point that Pathak noted does bring some limitations to the results. Subjects with permanent AF, previous AF ablation, and severe medical illnesses were excluded.
Each year for 4 years, participants reported for a health exam and an assessment of their AF symptoms, based on their own reports and 7 days’ worth of readings from a Holter monitor. Patients also underwent an echocardiogram and sonogram of the measure heart health.
As subjects progressed, they were categorized based on the percentage of body weight lost. Symptom curves show that the AF burden decreased far more for those who lost the most weight, with both weight loss and weight fluctuation being independent predictors of outcomes. At the 4-year mark, 45% of patients who lost at least 10% of their weight, and 22% of those who lost 3-9% of the weight were free of AF symptoms—without the need for surgery or any medication. By contrast, only 13% of patients who lost less than 3% of their weight were symptom-free without such treatments.
Both sustained weight management and an absence of weight fluctuation were associated with a lack of AF symptoms. Those who lost and regained more than 5% of weight between annual visits were twice as likely to experience symptoms. Stable weight loss also helped patients achieve improved blood pressure, cholesterol and blood sugar levels.
The study was simultaneously published in the Journal of the American College of Cardiology.
Reference
Pathak R, et al. Long-term effect of goal directed weight management in an atrial fibrillation cohort: A long-term follow-up study (LEGACY Study). J Am Coll Cardiol 2015; DOI:101016/jacc.2015.03.002.
Standard Criteria for Loss of Ambulation Needed in DMD
April 19th 2024A recent study suggests the differences between ambulation definitions for patients with Duchenne muscular dystrophy (DMD) can impact the identification of ambulant vs nonambulant individuals, and standard criteria across settings are needed.
Read More
The Importance of Examining and Preventing Atrial Fibrillation
August 29th 2023At this year’s American Society for Preventive Cardiology Congress on CVD Prevention, Emelia J. Benjamin, MD, ScM, delivered the Honorary Fellow Award Lecture, “The Imperative to Focus on the Prevention of Atrial Fibrillation,” as the recipient of this year’s Honorary Fellow of the American Society for Preventive Cardiology award.
Listen
An Overview of Health Care and Pharmaceutical Trends, 2023-2024
April 19th 2024Douglas M. Long, BA, MBA, was featured as the keynote speaker on the closing day of The Academy of Managed Care Pharmacy 2024 annual meeting, with a session dedicated to surveying the health care and pharmaceutical trends of the last year.
Read More
Promoting Equity in Public Health: Policy, Investment, and Community Engagement Solutions
June 28th 2022On this episode of Managed Care Cast, we speak with Georges C. Benjamin, MD, executive director of the American Public Health Association, on the core takeaways of his keynote session at AHIP 2022 on public health policy and other solutions to promote equitable health and well-being.
Listen
Collecting SDOH Data Can Assess Risk of Medical Nonadherence, Improve HEI and Star Ratings
April 18th 2024At the Academy of Managed Care Pharmacy (AMCP) 2024 annual meeting, a panel of presenters explored changes coming to Medicare that incorporate social determinants of health (SDOH) data to improve patient and health system outcomes.
Read More