NAFLD ups risk for myocardial infarction

Takeaway

• Nonalcoholic fatty liver disease (NAFLD) is independently associated with an increased risk for myocardial infarction (MI).

Why this matters

• Careful monitoring and early management may be necessary, even in mild NAFLD.

Study design

• Study of 111,492 patients aged >40 (mean, 52.0±8.1) years undergoing regular health exams over a 10-year period (2003-2013).
• Baseline NAFLD prevalence was 33.4%; most patients had low NAFLD fibrosis score (NFS; <–1.455, 72.3% vs ≥–1.455, 27.6%).
• Patients with history of cardiovascular disease, liver disease, or cancer were excluded.
• NAFLD was diagnosed via ultrasound.
• Funding: None.

Key results

• 183 patients experienced an MI over 725,706.9 person-years of follow-up, corresponding to an incidence rate of 2.5 cases per 10,000 person-years.
• NAFLD was tied to a doubled risk for MI (aHR=2.14; P<.01) in multivariate analysis adjusting for age, sex, and visit year.
• The association retained significance in fully adjusted models (aHR=1.54; P=.01) accounting for smoking, alcohol intake, metabolic factors, and medication use.
• In the fully adjusted model, MI risk was similar among patients with:
  • Low NFS score: aHR=1.70 (95% CI, 1.22-2.36).
  • Intermediate-high NFS score: aHR=1.88 (95% CI, 1.24-2.87).

Limitations

• Retrospective data.
• Absence of biopsy data.
• Korean population.