Non-alcoholic fatty liver disease (NAFLD), metabolic syndrome and cardiovascular events in atrial fibrillation. A prospective multicenter cohort study.
Aged
Aged, 80 and over
Atrial Fibrillation
/ epidemiology
Cardiovascular Diseases
/ complications
Cohort Studies
Correlation of Data
Female
Humans
Italy
/ epidemiology
Male
Metabolic Syndrome
/ complications
Non-alcoholic Fatty Liver Disease
/ complications
Proportional Hazards Models
Prospective Studies
Risk Factors
Atrial fibrillation
Cardiovascular events
Metabolic syndrome
NAFLD
Journal
Internal and emergency medicine
ISSN: 1970-9366
Titre abrégé: Intern Emerg Med
Pays: Italy
ID NLM: 101263418
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
22
11
2020
accepted:
17
02
2021
pubmed:
14
3
2021
medline:
30
11
2021
entrez:
13
3
2021
Statut:
ppublish
Résumé
Whether non-alcoholic fatty liver disease (NAFLD) is associated with an increased risk of cardiovascular events (CVEs) independently from metabolic syndrome (MetS) is still matter of debate. Aim of the study was to investigate the risk of CVEs in a high-risk population of patients with non-valvular atrial fibrillation (AF) according to the presence of MetS and NAFLD. Prospective observational multicenter study including 1,735 patients with non-valvular AF treated with vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs). NAFLD was defined by a fatty liver index ≥ 60. We categorized patients in 4 groups: 0 = neither MetS or NAFLD (38.6%), 1 = NAFLD alone (12.4%), 2 = MetS alone (19.3%), 3 = both MetS and NAFLD (29.7%). Primary endpoint was a composite of CVEs. Mean age was 75.4 ± 9.4 years, and 41.4% of patients were women. During a mean follow-up of 34.1 ± 22.8 months (4,926.8 patient-years), 155 CVEs were recorded (incidence rate of 3.1%/year): 55 occurred in Group 0 (2.92%/year), 12 in Group 1 (2.17%/year), 45 in Group 2 (4.58%/year) and 43 in Group 3 (2.85%/year). Multivariable Cox regression analysis showed that use of DOACs, and female sex were inversely associated with CVEs, whilst age, heart failure, previous cardiac and cerebrovascular events, and group 2 (Group 2, Hazard Ratio 1.517, 95% Confidence Interval, 1.010-2.280) were directly associated with CVEs. In patients with AF, MetS increases the risk of CVEs. Patients with NAFLD alone have lower cardiovascular risk but may experience higher liver-related complications.
Identifiants
pubmed: 33713286
doi: 10.1007/s11739-021-02682-3
pii: 10.1007/s11739-021-02682-3
pmc: PMC8563662
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
2063-2068Investigateurs
Mirella Saliola
(M)
Danilo Menichelli
(D)
Marco Antonio Casciaro
(MA)
Francesco Angelico
(F)
Vittoria Cammisotto
(V)
Cristina Nocella
(C)
Simona Bartimoccia
(S)
Roberto Carnevale
(R)
Laura Novelli
(L)
Informations de copyright
© 2021. The Author(s).
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