NAFLD ups risk for myocardial infarction

  • Sinn DH & al.
  • J Gastroenterol Hepatol
  • 11 Sep 2019

  • International Clinical Digest
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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;
  • 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.