Key result
NAFLD-related AF mortality in US adults increased ~9% annually from 1999 to 2023.
Observational (n=35,607)
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NAFLD-associated atrial fibrillation mortality in the US increased significantly from 1999 to 2023, highlighting the need for targeted interventions in high-risk demographic and geographic groups.
Introduction: Nonalcoholic Fatty Liver Disease (NAFLD) and Atrial Fibrillation (AFib) share common risk factors, including obesity, insulin resistance, and systemic inflammation, which may contribute to an increased risk of AF in individuals with NAFLD. Research Question: How have NAFLD and AF-related mortality trends changed in the U.S. from 1999 to 2023? Aims: To identify disparities and assess variations in mortality by age, sex, race/ethnicity, and geographic region. Methods: Age-adjusted mortality rates (AAMRs) per 100,000 among adults (25+) were extracted from CDC WONDER using ICD codes for AF and NAFLD. Joinpoint regression estimated Annual Percent Change (APC) and Average APC (AAPC) with significance at p<0.01. Results: Between 1999 and 2023, 35,607 NAFLD-related AF deaths occurred among adults, primarily in hospitals (48%) and homes (26.7%). AAMR rose from 0.21 in 1999 to 1.56 in 2023 (AAPC: 8.9%, p<0.000001), peaking in 2023. Men had higher AAMRs than women (0.79 vs. 0.40) while females experienced a greater increase (AAPC: 8.7%, p<0.000001). Non-Hispanic (NH) Whites had the highest AAMR (0.61), while NH Blacks had the greatest rise (AAPC: 9.0%, p<0.000001). Elderly (65Y+) had higher AAMRs (2.45) and showed a steeper increase (AAPC: 8.6%, p<0.000001) compared to young adults. Geographically, AAMRs ranged from 1.68 (West Virginia) to 0.35 (Florida), with the West showing the highest increase (AAPC: 9.4%, p<0.000001). Rural areas had higher AAMRs than urban (0.49 vs. 0.45), with both showing increasing trends. Conclusion: Significant mortality disparities exist in NAFLD associated AF patients, warranting targeted interventions for elderly men, NH Whites and Blacks, rural residents, and those from the West.
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Malik et al. (2025) conducted an observational in Nonalcoholic Fatty Liver Disease (NAFLD) and Atrial Fibrillation (AFib) (n=35,607). Calendar year (1999-2023) was evaluated on Age-adjusted mortality rates (AAMRs) per 100,000 (AAPC 8.9%, p=<0.000001). Between 1999 and 2023, the age-adjusted mortality rate for NAFLD-related atrial fibrillation in US adults increased significantly from 0.21 to 1.56 per 100,000 (AAPC: 8.9%, p<0.000001).
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