According to a study published in the BMJ, the diagnosis of non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH) is more weakly associated with risk for acute myocardial infarction (AMI) and stroke beyond known associated risk factors.
Researchers analysed people with NAFLD diagnosis from four European countries: Italy (n=1,542,672), the Netherlands (n=2,225,925), Spain (n=5,488,397) and the UK (n=12,695,046) and estimated the incident risk of developing AMI and stroke in routine practice. They assessed 205,046 cardiovascular events in 120,795 adults and 9,647,644 matched controls.
After adjustment for age, sex and smoking, the pooled hazard ratio (HR) for AMI and stroke in participants with NAFLD was 1.17 (95% CI, 1.05-1.30) and 1.18 (95% CI, 1.11-1.24), respectively. When adjusted for systolic blood pressure, type 2 diabetes, total cholesterol level, statin use and hypertension, the HR for AMI and stroke was 1.01 (95% CI, 0.91-1.12) and 1.04 (95% CI, 0.99-1.09), respectively.
“A diagnosis of NAFLD in routine clinical practice across Europe does not necessarily indicate the need for AMI or stroke preventive treatments. Rather, our results suggest that the risk of cardiovascular disease should be assessed in these people in the standard way using risk scores, with no strong case yet to consider NAFLD as a risk enhancer,” the authors wrote.