ArticleESC heart failure2022
Liver fibrosis scores and atrial fibrillation incidence in heart failure with preserved ejection fraction.
Article in ESC heart failure, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 21 citations in OpenAlex.
- FIB-4 Index as a Non-Invasive Biomarker of Congestion and Prognosis in Heart Failure.Journal of clinical medicine · 2026Review
- Effect of median liver stiffness on chronic heart failure by alcohol intake in the NHANES population: A cross-sectional study.Medicine · 2026Article
- Combined assessment of nonalcoholic fatty liver disease fibrosis score and B-type natriuretic peptide for predicting atrial fibrillation recurrence after catheter ablation: A multicenter study.Heart rhythm O2 · 2026Article
- Article
- New-Onset Atrial Fibrillation in Patients with Pacemakers and the Implications of Hepatic Impairment.Life (Basel, Switzerland) · 2025Article
- An investigation of the association between atrial fibrillation and the liver fibrosis-4 index in patients who underwent coronary computed tomography angiography.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Association of liver fibrosis scores with all-cause and cardiovascular mortality in patients with heart failure.Clinical and translational science · 2024Article
- Association Between Noninvasive Liver Fibrosis Scores and Heart Failure in a General Population.Journal of the American Heart Association · 2024Article
- Current Review of Heart Failure-Related Risk and Prognostic Factors.Biomedicines · 2024Review
- Non-Invasive Serum Markers of Non-Alcoholic Fatty Liver Disease Fibrosis: Potential Tools for Detecting Patients with Cardiovascular Disease.Reviews in cardiovascular medicine · 2024Review
- A Novel Liver Fibrosis Marker FIB-5 Index Predicted Response to Cardiac Resynchronization Therapy and Prognostic Outcomes in Patients With Heart Failure.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2024Article
- Elevated liver fibrosis-4 index predicts recurrence after catheter ablation for atrial fibrillation in patients with heart failure.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2024Article
- The Liver in Heart Failure: From Biomarkers to Clinical Risk.International journal of molecular sciences · 2023Review
- Serum Metabolites Are Associated With HFpEF in Biopsy-Proven Nonalcoholic Fatty Liver Disease.Journal of the American Heart Association · 2023Article
- The Liver-Heart Connection: A Literature Review of Liver Disease as a Risk Factor for Atrial Fibrillation.Cureus · 2023Review
- Association between FIB-4, all-cause mortality, cardiovascular mortality, and cardiovascular disease risk among diabetic individuals: NHANES 1999-2008.Frontiers in cardiovascular medicine · 2023Article
- Liver fibrosis scores and atrial fibrillation incidence in heart failure with preserved ejection fraction.ESC heart failure · 2022Article
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Authors and funding
13 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimNon-alcoholic fatty liver disease (NAFLD)-related advanced liver fibrosis (Stage 3 or 4) was reported to be linked to worse prognosis in patients with heart failure with preserved ejection fraction (HFpEF). This study aims to assess the relationship between liver fibrosis scores and new-onset atrial fibrillation (AF) incidence in patients with HFpEF in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial. METHODS AND
resultsBaseline liver fibrosis levels, assessed by NAFLD fibrosis score (NFS) or Fibrosis-4 index (FIB-4), with AF incidence were expressed as hazard ratios (HRs) using the Cox proportional hazard model. The risk for advanced fibrosis was estimated to be 21.5% (447/2072) as assessed by FIB-4 (>3.25) and 4.2% (88/2072) as assessed by NFS (>0.676) in HFpEF patients without baseline AF. After a median follow-up of 3.11 years, 106 new-onset AF cases occurred. In multivariate analysis, elevated NFS [NFS = -1.455-0.676: HR 2.44, 95% confidence interval (CI) 1.27-4.68; NFS > 0.676: HR 3.36, 95% CI 1.27-6.80; per 1 unit increase: HR 1.15, 95% CI 1.01-1.32], not FIB-4 (FIB-4 = 1.45-3.25: HR 1.02, 95% CI 0.67-1.55; FIB-4 > 3.25: HR 1.69, 95% CI 0.76-3.79; per 1 unit increase: HR 1.13, 95% CI 0.93-1.37), was associated with increased AF incidence. The NFS (C-index 0.662), not FIB-4 (C-index 0.531), had a moderate predictive ability in predicting incident AF.
conclusionsAmong patients with HFpEF, the risk of advanced liver fibrosis is associated with an increased incidence of new-onset AF and may be a novel predictor for new-onset AF. Additional studies are needed to confirm our results.
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