Prevalence and Impact of Nonalcoholic Fatty Liver Disease in Atrial Fibrillation
| Autor: | Daniele Pastori, Francesco Angelico, Claudia Iannilli, Elio Sabbatini, Francesco Violi, Maria Del Ben, Alessio Farcomeni, Marco Antonio Casciaro, Mirella Saliola, Maria Santulli, Pasquale Pignatelli, Cristina Nocella, Angela Sciacqua, Patrizia Iannucci, Rossella Marcucci, Francesco Perticone, Fortunata Vasaturo, Simona Bartimoccia, Francesco Baratta, Roberto Carnevale, Tiziana Di Stefano, Vittoria Cammisotto |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty heart failure atrial fibrillation NAFLD NOAC Gastroenterology Interquartile range Non-alcoholic Fatty Liver Disease Risk Factors Internal medicine Nonalcoholic fatty liver disease Atrial Fibrillation medicine Prevalence Humans Prospective Studies Prospective cohort study Aged business.industry Fatty liver Hazard ratio Anticoagulants Atrial fibrillation General Medicine medicine.disease Italy Female Metabolic syndrome business Settore SECS-S/01 Dyslipidemia |
| Popis: | Objective To estimate the prevalence of nonalcoholic fatty liver disease (NAFLD) and its impact on bleeding and thrombotic events in patients with atrial fibrillation (AF). Patients and Methods Prospective multicenter cohort study including patients with nonvalvular AF receiving vitamin K antagonists (VKAs) or non-VKA oral anticoagulants (NOACs) from February 2008 for patients on VKA and from September 2013 for patients on NOACs. NAFLD was diagnosed using the validated fatty liver index, with a cutoff score of 60 or higher. Primary end points were the occurrence of major bleedings and cardiovascular events (CVEs). Results NAFLD was diagnosed in 732 of 1735 (42.2%) patients. Patients with NAFLD were younger, less frequently women, and more likely to be treated with NOACs and to have obesity, dyslipidemia, and persistent/permanent AF. During a median follow-up of 18.7 months (3155 patient-years), we recorded 78 major bleedings (incidence rate, 2.5% per year): 29 (2.1% per year) in patients with and 49 (2.7% per year) in patients without NAFLD (log-rank test P=.23). Univariate Cox proportional regression analysis showed no association of NAFLD with major bleedings (hazard ratio, 0.75; 95% CI, 0.47-1.20; P=.23). One hundred fifty-five CVEs occurred (incidence rate, 3.1% per year). No significant association was found between NAFLD and CVEs (log-rank test P=.12). In the entire population, NOAC use was associated with lower CVEs compared with VKAs (hazard ratio, 0.61; 95% CI, 0.42-0.89; P=.01). Conclusion NAFLD is highly prevalent in AF but is not associated with higher bleeding or thrombotic risk. |
| Databáze: | OpenAIRE |
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