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±9.4years, and 41.4% of patients were women. During a mean follow-up of 34.1±22.8months (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.

Non-alcoholic fatty liver disease (NAFLD), metabolic syndrome and cardiovascular events in atrial fibrillation. a prospective multicenter cohort study / Pastori, Daniele; Sciacqua, Angela; Marcucci, Rossella; Del Ben, Maria; Baratta, Francesco; Violi, Francesco; Pignatelli, Pasquale; the ATHERO-AF study, Group; Menichelli, Danilo. - In: INTERNAL AND EMERGENCY MEDICINE. - ISSN 1828-0447. - 16:8(2021), pp. 2063-2068. [10.1007/s11739-021-02682-3]

Non-alcoholic fatty liver disease (NAFLD), metabolic syndrome and cardiovascular events in atrial fibrillation. a prospective multicenter cohort study

Pastori, Daniele
;
Del Ben, Maria;Baratta, Francesco;Violi, Francesco;Pignatelli, Pasquale;Menichelli, Danilo
Membro del Collaboration Group
2021

Abstract

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±9.4years, and 41.4% of patients were women. During a mean follow-up of 34.1±22.8months (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.
2021
atrial fibrillation; cardiovascular events; metabolic syndrome; NAFLD
01 Pubblicazione su rivista::01a Articolo in rivista
Non-alcoholic fatty liver disease (NAFLD), metabolic syndrome and cardiovascular events in atrial fibrillation. a prospective multicenter cohort study / Pastori, Daniele; Sciacqua, Angela; Marcucci, Rossella; Del Ben, Maria; Baratta, Francesco; Violi, Francesco; Pignatelli, Pasquale; the ATHERO-AF study, Group; Menichelli, Danilo. - In: INTERNAL AND EMERGENCY MEDICINE. - ISSN 1828-0447. - 16:8(2021), pp. 2063-2068. [10.1007/s11739-021-02682-3]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1517888
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