Liver fibrosis scores and atrial fibrillation incidence in heart failure with preserved ejection fraction.
ESC Heart Fail
; 9(6): 3985-3994, 2022 12.
Article
em En
| MEDLINE
| ID: mdl-35996808
ABSTRACT
AIM:
Non-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 ANDRESULTS:
Baseline 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.CONCLUSIONS:
Among 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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
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Hepatopatia Gordurosa não Alcoólica
/
Insuficiência Cardíaca
Tipo de estudo:
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article