Abstract 17675: Association Between Obesity and Heart Failure and Related Atrial Fibrillation: Patient-Level Data Comparisons of Two Cohort Studies

Introduction: Differences in obesity-mediated association between heart failure (HF) and HF-related atrial fibrillation (AF) among Asians and Europeans was evaluated.

Methods: Using the Korean National Health Insurance Service-Health Screening (K-NHIS-HealS) cohort and U.K. Biobank, we included 395,173 Korean and 477,214 UK adults aged 40-70 without previous HF who received check-ups. The incidence and risk of HF was evaluated in relation to different body mass index (BMI).

Results: The proportion of obese individuals was significantly higher in the UK Biobank (24.2%) compared to the K-NHIS-HealS cohort (2.7%, P<0.001). During the follow-up period of 7.3 and 11.7 years, 684 and 3,183 subjects in the K-NHIS-HealS cohort and UK Biobank, respectively, developed HF. The incidence of HF and HF-related AF was higher in the UK than in Korea across all BMI categories, even after age and sex adjustment. For obese individuals, the age- and sex-adjusted incidences of HF were 0.50 and 1.16 in Korea and the UK, respectively. The risk of HF was notably higher in the British population compared to Koreans, with adjusted hazard ratios of 1.81 (95% CI, 1.30-2.53) and 2.20 (95% CI, 1.98-2.45) in obese participants (P for interaction<0.001). After adjusting for clinical variables, a 5-unit increase in BMI was associated with a 52% greater risk of HF-related AF in the UK Biobank cohort (P<0.001), but not in the Korean NHIS-HealS cohort (P=0.275).

Conclusions: Obesity was associated with increased risk of HF and HF-related AF in both populations. The higher incidence in the UK population was likely because of the higher proportion of obese individuals.