Liver stiffness tied to atrial fibrillation

Liver stiffness appears to increase the likelihood of atrial fibrillation (AF), according to a recent sub-analysis of the Rotterdam Study. Fatty liver disease, on the other hand, does not affect AF risk.

The Rotterdam Study is a large, prospective, ongoing cohort study. The present analysis enrolled 5,825 participants (mean age 69.5 years, 42.9 percent men) who had undergone abdominal ultrasound between 2009 and 2014, excluding those who had no AF data available.

Steatosis was present in 35.7 percent of participants at baseline; meanwhile, liver stiffness ≥8.0 kPa was detected in 6.1 percent. AF was identified through the participants’ medical records, which showed a baseline prevalence of 7.0 percent.

Regression analysis revealed no interaction between hepatic steatosis and AF (odds ratio [OR], 0.80, 95 percent confidence interval [CI], 0.62–1.03), an effect that remained true when steatosis was replaced by nonalcoholic or metabolic-dysfunction associated fatty liver disease.

In contrast, liver stiffness ≥8.0 kPa, as measured by transient elastography, increased AF risk by more than double (OR, 2.08, 95 percent CI, 1.33–3.25). A similar pattern was reported when liver stiffness was taken as a continuous variable (OR, 1.09 per kPA, 95 percent CI, 1.03–1.16).

Of note, the link between liver stiffness and AF risk was consistently significant only in participants without steatosis. In patients with steatosis, adjusting for all confounders also attenuated the correlation between liver stiffness and AF (OR, 1.63, 95 percent CI, 0.82–3.47).