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MASLD Is Associated With an Increased Long-Term Risk of Atrial Fibrillation: An Updated Systematic Review and

Alessandro Mantovani1, Riccardo Morandin1, Elena Sani1

  • 1Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona, Italy.

Liver International : Official Journal of the International Association for the Study of the Liver
|December 25, 2024
PubMed
Abstract

Insights

Metabolic dysfunction-associated steatotic liver disease (MASLD) significantly increases the long-term risk of developing atrial fibrillation (AF). This association remained consistent across studies, highlighting a critical link between liver health and cardiac conditions.

Area of Science:

  • Cardiology
  • Hepatology
  • Epidemiology

Background:

  • Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized as a significant health concern.
  • Previous studies suggest a link between MASLD and an elevated risk of atrial fibrillation (AF).
  • The precise magnitude of this risk and its correlation with MASLD severity require further investigation.

Purpose of the Study:

  • To systematically review and meta-analyze existing cohort studies to quantify the association between MASLD and incident AF.
  • To determine if the severity of liver fibrosis in MASLD influences the risk of developing AF.
  • To provide updated evidence on the long-term risk of AF in individuals with MASLD.

Main Methods:

  • A systematic search of three major electronic databases was conducted for cohort studies published up to September 2024.
  • Studies included MASLD diagnosed via liver biopsy, imaging, ICD codes, or blood scores.
  • Meta-analysis employed random-effects modeling to assess the primary outcome of AF occurrence.

Main Results:

  • The analysis included 16 retrospective cohort studies encompassing approximately 19.5 million individuals.
  • MASLD was significantly associated with a 20% increased risk of incident AF (HR 1.20, 95% CI 1.10-1.32).
  • No significant increase in AF risk was observed with advancing liver fibrosis severity, and the association persisted after adjusting for cardiometabolic risk factors.

Conclusions:

  • This meta-analysis confirms a significant association between MASLD and an increased long-term risk of developing AF.
  • The findings underscore the importance of considering cardiac health in patients with MASLD.
  • Further research is warranted to elucidate the underlying mechanisms connecting MASLD and AF incidence.
Keywords:
MASLDNAFLDarrhythmiasatrial fibrillationmetabolic dysfunction‐associated steatotic liver diseasenon‐alcoholic fatty liver disease

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