Boriani G, et al. - Researchers assessed the link between body mass index (BMI) and outcomes in 21,028 atrial fibrillation (AF) patients randomized to warfarin (international normalized ratio 2.0–3.0) or edoxaban in the ENGAGE AF-TIMI 48 trial. With regard to BMI categories (kg/m²), 0.8% were underweight (<18.5), 21.4% were normal (18.5 to <25), 37.6% were overweight (25 to <30), 24.8% were moderately obese (30 to <35), 10.0% were severely obese (35 to <40), and 5.5% very severely obese (≥40). Findings revealed an independent association of increased BMI with a lower risk of stroke/systemic embolic event (SEE), better survival, but an increased risk of bleeding. A significant interaction between sex and increasing BMI category was also noted, with males having lower risk of ischemic stroke/SEE and females having increased risk of bleeding. Across BMI categories ranging from 18.5 to >40, similar efficacy and safety profiles of edoxaban were observed.