MASLD may Significantly Increases Long-Term Risk of Atrial Fibrillation, suggests study
Researchers have demonstrated that metabolic dysfunction-associated steatotic liver disease (MASLD) was found to increase the risk of atrial fibrillation (AF), significantly increasing the long-term risk and a condition associated with the severe cardiovascular complications. A recent study was conducted by Alessandro and colleagues which was published in the journal Liver International.
This systematic review and meta-analysis included cohort studies up to September 30, 2024. Electronic databases were searched to select the articles. Confirmation of MASLD diagnosis through biopsy of the liver, imaging techniques, ICD codes, or blood-based scores occurred. The key outcome studied was incident AF. Its assessment used ICD codes, medical records, or electrocardiograms. Synthesis used a random-effects model; sensitivity analyses validated the results.
Key Results
A total of 16 retrospective cohort studies including around 19.5 million individuals with a median follow-up time of 7.2 years were included in the analysis. Key results included the following:
• Incidence AF Risk: MASLD was associated with a 20% higher risk of incident AF (random-effects hazard ratio 1.20, 95% CI 1.10–1.32; I² = 92%).
• Liver Fibrosis Severity: The association remained when adjusted for liver fibrosis severity (random-effects hazard ratio 1.22, 95% CI 1.18–1.26; I² = 10%).
• Independent Risk Factor: The high risk of AF persisted even after controlling for confounding variables like age, sex, body mass index, hypertension, and Type 2 diabetes.
• No Publication Bias: Sensitivity analyses and funnel plots provided robust findings, and the Egger's test also did not indicate any publication bias at all.
This meta-analysis confirms MASLD significantly increases the risk of long-term incidence for atrial fibrillation; other cardiometabolic factors were independent. This work has underlined the necessity for recognition of MASLD as a significant contributor to diseases involving the cardiovascular system. Further targeted interventions need to be adopted for its effective management and complications. Further mechanisms on MASLD and development of AF need to be further studied in more detail.
Reference:
Mantovani A, Morandin R, Sani E, Fiorio V, Shtembari E, Bonapace S, Petta S, Polyzos SA, Byrne CD, Targher G. MASLD Is Associated With an Increased Long-Term Risk of Atrial Fibrillation: An Updated Systematic Review and Meta-Analysis. Liver Int. 2025 Jan;45(1):e16128. doi: 10.1111/liv.16218. PMID: 39720864.
