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Liver enzymes are not directly involved in atrial fibrillation: a prospective cohort study.

Schutte, R; Whincup, PH; Papacosta, O; Lennon, LT; Macfarlane, PW; Wannamethee, G (2017) Liver enzymes are not directly involved in atrial fibrillation: a prospective cohort study. Eur J Clin Invest, 47 (8). pp. 583-590. ISSN 1365-2362 https://doi.org/10.1111/eci.12779
SGUL Authors: Whincup, Peter Hynes

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Abstract

BACKGROUND: Epidemiological evidence proposes the direct involvement of the liver enzymes in atrial fibrillation. These relationships are controversial and mechanistically unclear. As part of the British Regional Heart Study, we investigated whether change in liver enzymes over time associates with atrial fibrillation in men initially free of this heart condition. MATERIALS AND METHODS: We prospectively investigated change (delta) in liver enzymes and new-onset atrial fibrillation in a representative sample of 1428 men aged 60-79 years. RESULTS: Mean follow-up was 12·3 years, after which 108 new atrial fibrillation cases were identified. The liver enzymes did not differ at baseline or follow-up, except for gamma-glutamyl transferase which was higher at follow-up in men who developed atrial fibrillation compared to those who did not (P < 0·0001). Change in GGT was greater in men who developed AF than those who did not (+6·12 vs. -2·60 U/L, P = 0·036). N-terminal pro-brain natriuretic peptide (baseline and follow-up, P < 0·0001) and total bilirubin (follow-up only, P < 0·0001) were also higher in men who developed atrial fibrillation while serum haemoglobin was similar at baseline and follow-up (P ≥ 0·74). Atrial fibrillation was associated with change in gamma-glutamyl transferase (OR, 1·18; 95% CI, 1·01-1·37) after multiple adjustments and exclusions. However, after adjusting for baseline (P = 0·088) or change (P = 0·40) in N-terminal pro-brain natriuretic peptide, the association between atrial fibrillation and change in gamma-glutamyl transferase was lost. CONCLUSION: The direct relationship between atrial fibrillation and liver enzymes is absent and depends, at least in part, on the progression of heart failure as captured by N-terminal pro-brain natriuretic peptide.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: Schutte, R; Whincup, PH; Papacosta, O; Lennon, LT; Macfarlane, PW; Wannamethee, G (2017) Liver enzymes are not directly involved in atrial fibrillation: a prospective cohort study. Eur J Clin Invest, 47 (8). pp. 583-590, which has been published in final form at http://doi.org/10.1111/eci.12779. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Keywords: Atrial fibrillation, heart failure, liver enzymes, General Clinical Medicine, 1103 Clinical Sciences
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: Eur J Clin Invest
ISSN: 1365-2362
Language: eng
Dates:
DateEvent
26 July 2017Published
29 June 2017Published Online
26 June 2017Accepted
Publisher License: Publisher's own licence
Projects:
Project IDFunderFunder ID
RG/08/013/25942British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
PG97012British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
PG/09/024British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
PubMed ID: 28664600
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/109024
Publisher's version: https://doi.org/10.1111/eci.12779

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