Association between non-alcoholic fatty liver disease and incidence of arrhythmia and other cardiovascular outcomes: a systematic review and meta-analysis. (25th January 2023)

• Record Type: Journal Article
• Authors: Jaiswal, V I K A S H; Ang, S O N G P; Hameed, M A H A; Momi, N K; Shah, M A I T R I; Kanakannavar, S S; Rajak, K R I P A; Kalra, K R I T I; Chia, J I A E E; Wajid, Z; Roy, S; Agrawal, V I B H O R; Sharma, P R A C H I; Jaiswal, A K A S H
• Is Part Of: European heart journal. Volume 44(2023)Supplement 1
• Publication Date: 2023-01-25
• Subjects: Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehac779.104
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Funding Acknowledgements: Type of funding sources: None. Background: The association between non-alcoholic fatty liver disease (NAFLD) with cardiovascular and cerebrovascular outcomes, as well as their clinical impact, has yet to be established in the literature. Objective: We aim to evaluate the association between NAFLD patients and the risk of atrial fibrillation (AF), heart failure (HF), stroke, cardiovascular mortality (CVM), and peripheral revascularization. Method: We performed a systematic literature search using the PubMed, Embase, Scopus, and Cochrane libraries for relevant articles from inception until July 20th, 2022. Odds ratios (OR) were pooled using a random-effect model, and a p-value of <0.05 was considered statistically significant. Results: A total of 10 studies with 17886340 patients (2887214 NAFLD vs 14999126 non-NAFLD) were included in our analysis. The average age and percentage of males were comparable between groups, with a mean age of 55 years and 72.5% of males in the NAFLD group, whereas 52 years and 47.4% of males in the non-NAFLD group. The most common comorbidities among the NAFLD group included: hypertension (38% vs 24%), diabetes mellitus (14% vs 8%). The mean follow-up duration was 6.26 years. The likelihood of atrial fibrillation [OR, 1.42(95%CI: 1.18-1.70), P<0.001], heart failure [OR, 1.48(95%CI: 1.27-1.73), P<0.001], stroke (OR, 1.26(95%CI: 1.17-1.36), P<0.001], and peripheral revascularization (OR, 3.95(95%CI: 1.60-9.73), P=0.003] was significantly higher in NAFLD patients when compared with non-NAFLD patients. In contrast, cardiovascular mortality was comparable between both the groups of patients [OR, 3.11(95%CI: 0.32-30.03), P=0.33] respectively. Conclusion: Patients with NAFLD demonstrated increased incidence of cardiovascular and/or cerebrovascular outcomes; heart failure, stroke, and arrhythmia. Patients with associated comorbidities were at higher risk of cardiovascular disease, implying a greater need for screening and adoption of cardio-protective measures amongst NAFLD patients. Forest Plot of Cardiovascular Outcomes