Lipids & metabolic liver disease
Incident cardiac arrhythmias associated with metabolic dysfunction-associated steatotic liver disease: a nationwide histology cohort study
Authors' conclusion
Compared to matched controls, patients with biopsy-confirmed MASLD had modest but significantly higher incidence of cardiac arrhythmias, including AF, bradyarrhythmias, other supraventricular arrhythmias and ventricular arrhythmias/cardiac arrest. Excess risk was observed across all stages of MASLD and was highest with cirrhosis.
Study context
- Population
- Swedish adults with histologically-confirmed MASLD and no prior cardiac arrhythmias, 1966–2016matched cohort
- Participants
- 11,206 vs 51,856
- Exposure
- Biopsy-confirmed MASLD vs matched controls without MASLD
- MASLDn = 11,206
- Controlsn = 51,856reference
- Outcome
- Incident arrhythmias (AF, bradyarrhythmias, other supraventricular arrhythmias, ventricular arrhythmias/cardiac arrest)
- Follow-up
- Median 10.8 years
Methodological detailsnationwide, histology cohort, matched controls (age, sex, calendar year, county), Cox proportional hazards
- Nationwide
- Histology cohort
- Matched controls (age, sex, calendar year, county)
- Cox proportional hazards
Main finding
As reported in the abstract
Incident arrhythmias
MASLD
10.3/1000 person-years
1351 of 11,206
Controls
8.7/1000PY
6493 of 51,856
Each group vs controlsAdjusted hazard ratio (95% CI)
MASLD
1.30(1.22–1.38)
- MASLD
- difference 1.7 /1000PY
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| Incident AFMASLDvs Controls | 1.26 (1.18–1.35) | |
| Incident ventricular arrhythmias/cardiac arrest | 1.53 (1.30–1.80) | |
| Incident bradyarrhythmias | 1.26 (1.06–1.48) | |
| Other supraventricular arrhythmias | 1.27 (1.00–1.62) | |
| 0.512Adjusted hazard ratio (log scale) |
| Outcome | Difference (/1000PY) |
|---|---|
| Incident AFMASLD vs Controls | 0.9 |
Overall arrhythmias and atrial fibrillation (AF) by MASLD histological group
- Cirrhosis: difference in overall arrhythmias
- 8.5/1000PY
- Cirrhosis: difference in AF
- 5.3/1000PY
- Rates significantly elevated across all MASLD histological groups
Original publication
Incident cardiac arrhythmias associated with metabolic dysfunction-associated steatotic liver disease: a nationwide histology cohort study. Cardiovasc Diabetol. Published 13 December 2023. doi:10.
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