Filippo Valbusa1, Davide Agnoletti1, Luca Scala1, Cristina Grillo1, Pietro Arduini2, Stefano Bonapace3, Stefano Calabria1, Giuliana Scaturro1, Alessandro Mantovani4, Giacomo Zoppini4, Emanuela Turcato2, Aldo Pietro Maggioni5, Guido Arcaro1, Giovanni Targher6. 1. Division of General Medicine "Sacro Cuore-Don Calabria" Hospital, Negrar, VR, Italy. 2. Division of Geriatrics, "Sacro Cuore-Don Calabria" Hospital, Negrar, VR, Italy. 3. Division of Cardiology, "Sacro Cuore-Don Calabria" Hospital, Negrar, VR, Italy. 4. Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy. 5. ANMCO Research Center, Florence, Italy. 6. Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy. Electronic address: giovanni.targher@univr.it.
Abstract
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is an emerging risk factor for incident heart failure (HF). It is currently unknown whether NAFLD predicts all-cause mortality in patients admitted for acute HF. We aimed to assess whether NAFLD and its severity (diagnosed by ultrasonography and non-invasive fibrosis biomarkers) were associated with increased all-cause mortality in this particularly high-risk patient population. METHODS: We studied 264 elderly patients, who were consecutively admitted for acute HF to the hospital between years 2013 and 2015, after excluding those with acute myocardial infarction, severe valvular heart diseases, kidney failure, cancer, cirrhosis of any etiology or known chronic liver diseases. Follow-up of patients continued until November 1, 2017. RESULTS: Over a mean follow-up of 23.2 months (range: 1 day-58 months), there were 140 (53%) total deaths. Of these, 24 deaths occurred during the first hospital admission (in-hospital death) and 116 deaths occurred after the hospital discharge during the follow-up period. Patients with NAFLD at hospital admission had significantly higher cumulative incidence rates of in-hospital and post-discharge all-cause mortality (singly or in combination) compared with those without NAFLD. This mortality risk was particularly high among patients with advanced NAFLD fibrosis. In Cox regression analysis, NAFLD was associated with an increased risk of all-cause mortality (adjusted-hazard ratio 1.82, 95% confidence intervals 1.22-2.81, p < 0.005) even after adjustment for established risk factors and potential confounding variables. CONCLUSIONS: NAFLD and its severity were independently associated with increased risk of in-hospital and post-discharge all-cause mortality in elderly patients admitted for acute HF.
BACKGROUND:Nonalcoholic fatty liver disease (NAFLD) is an emerging risk factor for incident heart failure (HF). It is currently unknown whether NAFLD predicts all-cause mortality in patients admitted for acute HF. We aimed to assess whether NAFLD and its severity (diagnosed by ultrasonography and non-invasive fibrosis biomarkers) were associated with increased all-cause mortality in this particularly high-risk patient population. METHODS: We studied 264 elderly patients, who were consecutively admitted for acute HF to the hospital between years 2013 and 2015, after excluding those with acute myocardial infarction, severe valvular heart diseases, kidney failure, cancer, cirrhosis of any etiology or known chronic liver diseases. Follow-up of patients continued until November 1, 2017. RESULTS: Over a mean follow-up of 23.2 months (range: 1 day-58 months), there were 140 (53%) total deaths. Of these, 24 deaths occurred during the first hospital admission (in-hospital death) and 116 deaths occurred after the hospital discharge during the follow-up period. Patients with NAFLD at hospital admission had significantly higher cumulative incidence rates of in-hospital and post-discharge all-cause mortality (singly or in combination) compared with those without NAFLD. This mortality risk was particularly high among patients with advanced NAFLD fibrosis. In Cox regression analysis, NAFLD was associated with an increased risk of all-cause mortality (adjusted-hazard ratio 1.82, 95% confidence intervals 1.22-2.81, p < 0.005) even after adjustment for established risk factors and potential confounding variables. CONCLUSIONS: NAFLD and its severity were independently associated with increased risk of in-hospital and post-discharge all-cause mortality in elderly patients admitted for acute HF.
Authors: Claudio Tana; Stefano Ballestri; Fabrizio Ricci; Angelo Di Vincenzo; Andrea Ticinesi; Sabina Gallina; Maria Adele Giamberardino; Francesco Cipollone; Richard Sutton; Roberto Vettor; Artur Fedorowski; Tiziana Meschi Journal: Int J Environ Res Public Health Date: 2019-08-26 Impact factor: 3.390
Authors: Jake P Mann; Paul Carter; Matthew J Armstrong; Hesham K Abdelaziz; Hardeep Uppal; Billal Patel; Suresh Chandran; Ranjit More; Philip N Newsome; Rahul Potluri Journal: PLoS One Date: 2020-10-27 Impact factor: 3.240