Key result
Non-alcoholic fatty liver disease was independently associated with a 10-year increased risk of incident atrial fibrillation in type 2 diabetic patients (HR 4.96; 95% CI 1.42-17.28).
Why the study?
Recent studies examining the association between non-alcoholic fatty liver disease and the risk of atrial fibrillation in adults have reported inconsistent findings.
Does non-alcoholic fatty liver disease increase the risk of atrial fibrillation in adult individuals?
Meta-Analysis
Does non-alcoholic fatty liver disease increase the risk of atrial fibrillation in adult individuals?
Hazard Ratio: 4.96 (95% CI 1.42–17.28)
NAFLD is independently associated with an increased risk of atrial fibrillation, particularly in patients with type 2 diabetes, suggesting a potential need for heightened AF surveillance in this population.
May warrant closer AF monitoring in diabetic NAFLD; leaves open whether NAFLD modification reduces incident AF.
BACKGROUND & AIMS: Recent studies examined the association between non-alcoholic fatty liver disease (NAFLD) and risk of atrial fibrillation (AF) in adults, but the findings have been inconsistent. We provided a quantitative estimate of the magnitude of the association between NAFLD and risk of AF. METHODS: We searched publication databases using predefined keywords to identify observational studies (published up to December 14, 2018), in which NAFLD was diagnosed by biopsy, imaging or biochemistry and AF was diagnosed by medical history and electrocardiograms. Data from selected studies were extracted and meta-analysis was performed using random-effects modelling. RESULTS: = 54.7%), independent of age, sex, body mass index, hypertension and other common AF risk factors. This risk was particularly high among patients with established diabetes (n = 1 study; random-effects odds ratio 5.17, 95% CI 2.05-13.02). Meta-analysis of data from 4 longitudinal studies showed that NAFLD was independently associated with a 10-year increased risk of incident AF only in type 2 diabetic patients (n = 1 study; random-effects hazard ratio 4.96, 95% CI 1.42-17.28). Sensitivity analyses did not modify these findings. Funnel plots did not reveal significant publication bias. CONCLUSIONS: NAFLD is associated with an increased risk of AF in middle-aged and elderly individuals (especially in those with type 2 diabetes). However, the observational design of the eligible studies does not allow for proving causality.
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Mantovani et al. (2019) conducted a meta-analysis in Non-alcoholic fatty liver disease and atrial fibrillation. Non-alcoholic fatty liver disease (NAFLD) vs. No NAFLD was evaluated on Incident atrial fibrillation in type 2 diabetic patients (HR 4.96, 95% CI 1.42-17.28). Non-alcoholic fatty liver disease was independently associated with a 10-year increased risk of incident atrial fibrillation in type 2 diabetic patients (HR 4.96; 95% CI 1.42-17.28).
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