ArticleLiver international : official journal of the International Association for the Study of the Liver2019
Atrial fibrillation is highly prevalent yet undertreated in patients with biopsy-proven nonalcoholic steatohepatitis.
Article in Liver international : official journal of the International Association for the Study of the Liver, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Cardiovascular Disease in the Context of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Comprehensive Narrative Review.International journal of molecular sciences · 2025Pooled it
- Relationship between non-alcoholic fatty liver disease and cardiac arrhythmia: a systematic review and meta-analysis.The Journal of international medical research · 2021Pooled it
- Sudden cardiac death associated with fatty liver disease.International journal of cardiology. Heart & vasculature · 2025Article
- A Mendelian randomization study reveals a causal association between NASH and the risk of atrial fibrillation.Frontiers in endocrinology · 2025Article
- Liver fibrosis scores can also be used as a marker of cardiovascular risk in non-alcoholic fatty liver disease.Northern clinics of Istanbul · 2025Article
- Risk of Adverse Events in Anticoagulated Patients With Atrial Fibrillation and Nonalcoholic Fatty Liver Disease.The Journal of clinical endocrinology and metabolism · 2024Article
- Incident cardiac arrhythmias associated with metabolic dysfunction-associated steatotic liver disease: a nationwide histology cohort study.Cardiovascular diabetology · 2023Article
- Review
- TASL Practice Guidance on the Clinical Assessment and Management of Patients with Nonalcoholic Fatty Liver Disease.Hepatology forum · 2023Article
- The Burden of Nonalcoholic Steatohepatitis: A Systematic Review of Epidemiology Studies.Gastro hep advances · 2022Review
- Liver Fibrosis is Associated with Ischemic Stroke Risk in Women but not Men: The REGARDS Study.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2021Article
- Non-alcoholic fatty liver disease and heart failure with preserved ejection fraction: from pathophysiology to practical issues.ESC heart failure · 2021Review
- Cardiovascular Disease in Nonalcoholic Steatohepatitis: Screening and Management.Current hepatology reports · 2020Article
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6 authors.
Funding
Abstract
BACKGROUND &
aimsNonalcoholic steatohepatitis (NASH) is associated with increased cardiovascular disease. Atrial fibrillation is a prominent risk marker for underlying cardiovascular disease with a prevalence of 2% in patients <65 years old. Atrial fibrillation prevalence in NASH is unknown. We sought to assess the prevalence and impact of atrial fibrillation on healthcare utilization in NASH.
methodsPatients were identified from a tertiary care centre Electronic Database from 2002 to 2015. International Classification of Diseases 9 (ICD9) codes identified comorbidities and atrial fibrillation. Descriptive statistics were used to compare characteristics between patients with NASH with and without atrial fibrillation.
resultsOf 9108 patients with ICD9 diagnosis of NASH, 215 (2.3%, mean age 57 years, 32% male) had biopsy-proven NASH. Atrial fibrillation prevalence was 4.6%. Patients with NASH and atrial fibrillation had a higher prevalence of heart failure (54.5% vs 8.8%, P < 0.001) and cerebrovascular (27.3% vs 2.0%, P < 0.001) or vascular disease (54.5% vs 13.2%, P = 0.002), compared to NASH without atrial fibrillation. All patients with NASH and atrial fibrillation had a CHA2DS2VASc score ≥2 indicating high stroke risk and need for anticoagulation. Eight of 10 patients were eligible for anticoagulation and 5 of 8 (62.5%) received appropriate therapy.
conclusionAtrial fibrillation prevalence is two-fold higher in patients with NASH compared to the general population. Patients with NASH have a high risk of stroke; however, many do not receive appropriate guideline-directed therapy. Future studies are needed to identify whether guideline-based management of atrial fibrillation in NASH reduces cardiovascular morbidity and mortality.
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