P3799 - NASH Predicts Heart Failure in Patients With NAFLD

Arnold Forlemu, MD, MPH¹, Raissa Nana Sede Mbakop, MD², Hamsika Moparty, MD¹, William Sayegh, MD¹, Srilaxmi Gujjula, MD¹, Vikash Kumar, MD¹, Naresh kumar, MD¹, Pavani Reddy Garlapati, MD¹, Saigopal R. Gujjula, ³, Vishnu Poojitha Ronda, MD¹, Praneeth Bandaru, MD¹, Vijay Gayam, MD¹, Denzil Etienne, MD¹, Madhavi Reddy, MD^1
1Brooklyn Hospital Center, Brooklyn, NY; ²Piedmont Athens Regional Medical Center, Athens, GA; ³American University of Antigua, Coolidge, Saint John, Antigua and Barbuda

Introduction: Non-alcoholic fatty liver disease (NAFLD) with a prevalence of 25% is the most common cause of liver disease worldwide. Non-alcoholic steatohepatitis (NASH) constitutes about 2 to 7% of these patients and can progress to cirrhosis and liver cancer. Likewise, the most common cause of death in patients with NAFLD is cardiovascular diseases (CVD), accounting for about 40% of deaths. Prior studies investigating the association between NAFLD and coronary artery disease (CAD) have produced conflicting results with suggestions that the main contributing factors to CVD were NASH and fibrosis. Furthermore, few studies have looked into the association between NASH and heart failure. We evaluated the association between NASH and coronary artery disease (CAD) and heart failure using a large National Inpatient Sample (NIS) database

Methods: We conducted a nationwide review from 2016 to 2017 using NIS data. NIS is the largest publicly available all-payer inpatient database in the United States with more than seven million hospital stays each year, as a part of the Healthcare Cost and Utilization Project (HCUP). Patient ≥ 18 years old with NAFLD, NASH, CAD, and heart failure were identified using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. Adjusted odds ratio (OR) and confidence intervals (CI) at 99% were reported.

Results: We identified 170,999 patients with NAFLD. Of these patients, 36,365 had NASH. The mean age of participants was 56 years with a female predominance at 54.5%. NASH was associated with an increased risk of CAD (23.4% vs 17.4%, p< 0.001) and heart failure (55.8% vs 48.5%, p< 0.001). On multivariate analysis, NASH was an independent risk factor for both CAD and heart failure in NAFLD patients. Table 1

Discussion: We found that NASH is a risk factor for heart failure in patients with NAFLD independent of cirrhosis and other traditional cardiovascular risk factors. It has been suggested that chronic inflammatory state, oxidative stress, and dysregulatory of coagulatory balance combined with endothelial dysfunction that are known to drive NAFLD progression may also accelerate atherogenesis. An experimental study has also suggested NASH to be linked with changes in myocardial structure that can lead to left ventricular diastolic function. Prospective studies are needed to further evaluate this association and to develop preventive strategies for heart failure in NALFD patients with NASH.


Disclosures:


Arnold Forlemu, MD, MPH¹, Raissa Nana Sede Mbakop, MD², Hamsika Moparty, MD¹, William Sayegh, MD¹, Srilaxmi Gujjula, MD¹, Vikash Kumar, MD¹, Naresh kumar, MD¹, Pavani Reddy Garlapati, MD¹, Saigopal R. Gujjula, ³, Vishnu Poojitha Ronda, MD¹, Praneeth Bandaru, MD¹, Vijay Gayam, MD¹, Denzil Etienne, MD¹, Madhavi Reddy, MD¹. P3799 - NASH Predicts Heart Failure in Patients With NAFLD, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.