Arrhythmias & electrophysiologyCohort study

Liver fibrosis and sudden cardiac arrest: A prospective cohort study of 452,454 individuals

Heart RhythmPublished

  • prospective cohort study

Authors' conclusion

Liver fibrosis, as assessed by the FIB-4 index, is an independent and graded predictor of SCA risk in the general population. This readily available biomarker could enhance SCA risk stratification and primary prevention strategies.

Study context

Population
Participants from the United Kingdom Biobankparticipants from the United Kingdom Biobank, median age 58 years, 45.8% male
Participants
452,454 participants
Exposure
Liver fibrosis and incident sudden cardiac arrest (SCA)
Outcome
Incident SCA
Follow-up
Median 13.8 years

Main finding

As reported in the abstract

Each group vs lowAdjusted hazard ratio (95% CI)
indeterminate
1.26(1.15–1.39)
high
1.69(1.36–2.12)
incident SCA cases
2889
Higher cumulative incidence of SCA with higher FIB-4 scores
log-rank P < .001

Observational data: associations, not effects.

Further findings

Outcomeadjusted HR (95% CI)
Dose-response, continuous FIB-4 index and SCA risk · 20% higher SCA risk1.20 (1.15–1.27)

Dose-response, continuous FIB-4 index and SCA risk

nonlinear yet positive association

Original publication

Liver fibrosis and sudden cardiac arrest: A prospective cohort study of 452,454 individuals. Heart Rhythm. Published 25 January 2026. doi:10.1016/j.hrthm.2026.01.029

Summarised from the published abstract; every number is checked against it