P1814 - Liver Fibrosis: An Independent Risk Factor for Cardiovascular Disease in Patients with Non-alcoholic Fatty Liver Disease

Bridgette B. McNally, DO¹, Michael Fallon, MD¹, Pooja Rangan, MBBS, MPH^2
1University of Arizona College of Medicine, Phoenix, AZ; ²University of Arizona College of Medicine Phoenix; Banner University Medical Center Phoenix, Phoenix, AZ

Introduction: The prevalence of non-alcoholic fatty liver disease (NAFLD) is nearly 25% among adults in the US. The leading cause of death in NAFLD is Cardiovascular disease (CVD). Studies have shown that the risk factors for NAFLD and CVD are similar; however, NAFLD appears to be an independent risk factor for cardiovascular related morbidity and all-cause mortality. Nevertheless, the American Association for the Study of Liver Disease does not advise routine screening for NAFLD in high risk groups. The purpose of this study was to compare characteristics of patients diagnosed with NAFLD with or without concomitant Coronary Artery Disease (CAD).



Methods: Retrospective chart review of de-identified data of NAFLD patients treated at a single center from January 2016-October 2020 was performed. Only patients who had multiple encounters (3 or more) at this single center were included. Data was collected from the date of the last encounter within the calendar year and laboratory data was taken within three months of the encounter date. NAFLD, CAD and other concomitant diseases diagnoses were based on ICD-10 codes. Demographics, including sex, race, age and BMI were recorded. Descriptive statistics and logistic regression for multivariate analysis were performed.

Results: 5,288 unique NAFLD patients were included; 60.1% female with an average age of 52.4 ± 15.6 years. Fifty percent of the study population was white and 34.3% was Hispanic. Ninety-five percent had hypertension, 83.2% had hyperlipidemia and 69.8% had diabetes. On univariate analysis, increasing age, male gender, hypertension, diabetes, hyperlipidemia, non-Hispanic ethnicity, and elevated Fibrosis-4 (Non-invasive serum-based liver fibrosis assessment; score ≥2) were significantly associated with presence of concomitant CAD. On multivariate regression, hypertension, hyperlipidemia, gender, Fibrosis-4, diabetes, and age were independent risk factors in descending order of odds ratio (table). No multicollinearity was seen between the predictors included in our study.

Discussion: Our study demonstrates that, in addition to well-described cardiovascular risk factors, the presence of liver fibrosis appears to be an independent risk factor for CAD in NAFLD patients. Interventions which define the degree of liver fibrosis in NAFLD patients and target the progression of fibrosis may be new avenues for decreasing the burden of CAD and associated adverse cardiovascular outcomes in NAFLD patients.


Disclosures:


Bridgette B. McNally, DO¹, Michael Fallon, MD¹, Pooja Rangan, MBBS, MPH². P1814 - Liver Fibrosis: An Independent Risk Factor for Cardiovascular Disease in Patients with Non-alcoholic Fatty Liver Disease, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.