Commentary
Epidemiological studies focusing on the association between liver disease and atrial fibrillation show inconsistent findings. Patients with liver disease have a higher atrial fibrillation risk. A recent meta-analysis by Karn Wijarnpreecha et al. (Department of Internal Medicine, Bassett Medical Centre, Cooperstown, NY, USA), published in 2017, showed that the risk of atrial fibrillation in patients with NAFLD was significantly higher than subjects without NAFLD with the pooled risks ratio of 2.06 (95% confidence interval, 1.10–3.85). However, it is unknown whether the liver fibrosis index can predict atrial fibrillation risk.
The medical records of a healthy population undergoing routine health examinations at Healthcare System Gangnam Centre, Seoul National University Hospital, were reviewed retrospectively. After excluding subjects with a history of liver disease and known cardiovascular disease, 74,946 subjects with non-alcoholic fatty liver disease (NAFLD) were evaluated.
The fibrosis 4 index (FIB 4) showed significant correlations with atrial fibrillation (adjusted with cardiometabolic risk factors OR 2.255 and 95% CI 1.744-2.915, p = 0.000). The non-invasive determination of liver fibrosis indices can have clinical implications on the early identification of NAFLD in patients at risk for AF.
