BACKGROUND: Extremes of body weight may alter exposure to non-vitamin K antagonist oral anticoagulants and thereby impact clinical outcomes. This ETNA-AF-Europe sub-analysis assessed 1-year outcomes in routine care patients with atrial fibrillation across a range of body weight groups treated with edoxaban. METHODS: ETNA-AF-Europe is a multinational, multicentre, observational study conducted in 825 sites in 10 European countries. Overall, 1310, 5565, 4346 and 1446 enrolled patients were categorised into ≤60 kg, >60-≤80 kg (reference weight group), >80-≤100 kg and >100 kg groups. RESULTS: Patients weighing ≤60 kg were older, more frail and had a higher CHA2DS2-VASc score vs. the other weight groups. The rates of stroke/systemic embolism, major bleeding and ICH were low at 1 year (0.82, 1.05 and 0.24%/year), with no significant differences among weight groups. The annualised event rates of all-cause death were 3.50%/year in the overall population. After adjustment for eGFR and CHA2DS2-VASc score, the risk of all-cause death was significantly higher in extreme weight groups vs. the reference group. CONCLUSIONS: Low rates of stroke and bleeding were reported with edoxaban, independent of weight. The risk of all-cause death was higher in extremes of weight vs. the reference group after adjustment for important risk modifiers, thus no obesity paradox was observed.

Cardiology Division Department of Biomedical Metabolic and Neural Sciences University of Modena and Reggio Emilia Policlinico di Modena 41100 Modena Italy

Chair of Cardiology Cardiology Division Pisa University Hospital University of Pisa Via Paradisa 2 56124 Pisa Italy

Daiichi Sankyo Europe GmbH Zielstattstraße 48 81379 Munich Germany

Department of Cardiology University Heart and Vascular Centre UKE Hamburg 20246 Hamburg Germany

Fondazione Villa Serena per la Ricerca Città Sant'Angelo 65013 Pescara Italy

Institute of Cardiovascular Sciences University of Birmingham SWBH and UHB NHS Trusts Birmingham B152TT UK

Institute of Computer Science of the Czech Academy of Sciences 18207 Prague Czech Republic

The Atrial Fibrillation NETwork 48149 Münster Germany

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