{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:50:43Z","timestamp":1784872243539,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In patients with atrial fibrillation (AF), the impact of liver disease (LD) on oral anticoagulant (OAC) prescription and outcomes remains unclear, as well as possible differences between European and Asian populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine the impact of LD on OAC prescriptions and risks of adverse outcomes in a large cohort of European and Asian AF patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>AF patients were derived from two large observational registries held in Europe and Asia. OAC prescription and risk of outcomes were analysed according to LD at baseline. The primary outcome was the composite of all\u2010cause death and major adverse cardiovascular events (MACEs). Logistic regression assessed associations with OAC prescription, and Cox regression analyses evaluated risks of outcomes. Interaction analyses were performed between European and Asian patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 15,681 patients (mean age 68.4\u2009\u00b1\u200910.7\u2009years; 37.1% female), 517 (3.3%) had LD. The OAC prescription rate was similar among European and Asian individuals (6.8% vs. 82.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.113). After adjustments, LD was associated with lower OAC prescription (OR .67, 95% CI .53\u2013.84), with a greater reduction in European than in Asian patients (\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>int<\/jats:sub>\n                      \u2009=\u2009.015). LD was associated with a higher risk of the composite outcome (HR 1.42, 95% CI 1.11\u20131.81) and MACEs (HR 1.47, 95% CI 1.07\u20132.02), with no significant European versus Asian differences (\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>int<\/jats:sub>\n                      \u2009=\u2009.631). Among LD patients, those not prescribed OAC had a higher MACE risk compared with those prescribed OAC (\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>int<\/jats:sub>\n                      \u2009=\u2009.050), with no differences in major bleeding.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In AF, LD is associated with reduced OAC prescription, especially in Europe, and a higher risk of adverse outcomes, particularly in patients not receiving OAC, with no significant differences between European and Asian cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eci.70193","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:06:39Z","timestamp":1774519599000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Liver disease in management and outcomes of European and Asian patients with atrial fibrillation: A report from two observational prospective registries"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6345-3742","authenticated-orcid":false,"given":"Davide Antonio","family":"Mei","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences Italy University of Modena and Reggio Emilia, Policlinico di Modena  Modena Italy"},{"name":"Clinical and Experimental Medicine PhD Program University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Bucci","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3788-8942","authenticated-orcid":false,"given":"Giulio Francesco","family":"Romiti","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Department of Translational and Precision Medicine Sapienza \u2013 University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernadette","family":"Corica","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences Italy University of Modena and Reggio Emilia, Policlinico di Modena  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alena","family":"Shantsila","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung\u2010Fat","family":"Tse","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, School of Clinical Medicine Queen Mary Hospital, the University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9820-4815","authenticated-orcid":false,"given":"Giuseppe","family":"Boriani","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences Italy University of Modena and Reggio Emilia, Policlinico di Modena  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6587-3094","authenticated-orcid":false,"given":"Tze\u2010Fan","family":"Chao","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Institute of Clinical Medicine, and Cardiovascular Research Center National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1452-2478","authenticated-orcid":false,"given":"Marco","family":"Proietti","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health University of Milan  Milan Italy"},{"name":"Division of Subacute Care IRCCS Istituti Clinici Scientifici Maugeri  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart &amp; Chest Hospital  Liverpool UK"},{"name":"Department of Clinical Medicine Aalborg University  Aalborg Denmark"},{"name":"Department of Cardiology, Lipidology and Internal Medicine with Intensive Coronary Care Unit Medical University of Bialystok  Bialystok Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-014-0145-y"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29466"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2023.100786"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjqcco\/qcaa093"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinre.2017.08.001"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-305756"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae176"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-2595-5575"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2296-13-5"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1011170"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eux301"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euab327"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-024-03792-3"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11357\u2010025\u201002026\u20105"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euaf229"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2016.12.033"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.11.050"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.03.023"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-022478"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcvp\/pvaa015"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/jgh3.12275"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.043"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.113.000817"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euab065"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.026863"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.005307"},{"issue":"4","key":"e_1_2_9_28_1","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.dld.2018.12.001","article-title":"Efficacy and safety of anticoagulation for atrial fibrillation in patients with cirrhosis: a systematic review and meta\u2010analysis","volume":"51","author":"Chokesuwattanaskul R","year":"2019","journal-title":"Digestive and Liver Disease: Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-025-03511-2"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.01.052"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-1769612"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-1772773"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euaf076"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2007.07.020"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.71.1610"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euab319"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1253\/jcj.53.108"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2025.02.013"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-2278-8769"}],"container-title":["European Journal of Clinical Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eci.70193","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/eci.70193","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/eci.70193","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T10:21:50Z","timestamp":1776766910000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/eci.70193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,26]]},"references-count":38,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/eci.70193"],"URL":"https:\/\/doi.org\/10.1111\/eci.70193","archive":["Portico"],"relation":{},"ISSN":["0014-2972","1365-2362"],"issn-type":[{"value":"0014-2972","type":"print"},{"value":"1365-2362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,26]]},"assertion":[{"value":"2025-11-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70193"}}