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Nonalcoholic Fatty Liver Disease and Risk of Heart Failure Among Medicare Beneficiaries.

Publication ,  Journal Article
Fudim, M; Zhong, L; Patel, KV; Khera, R; Abdelmalek, MF; Diehl, AM; McGarrah, RW; Molinger, J; Moylan, CA; Rao, VN; Wegermann, K; Neeland, IJ ...
Published in: J Am Heart Assoc
November 16, 2021

Background Nonalcoholic fatty liver disease (NAFLD) and heart failure (HF) are increasing in prevalence. The independent association between NAFLD and downstream risk of HF and HF subtypes (HF with preserved ejection fraction and HF with reduced ejection fraction) is not well established. Methods and Results This was a retrospective, cohort study among Medicare beneficiaries. We selected Medicare beneficiaries without known prior diagnosis of HF. NAFLD was defined using presence of 1 inpatient or 2 outpatient claims using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), claims codes. Incident HF was defined using at least 1 inpatient or at least 2 outpatient HF claims during the follow-up period (October 2015-December 2016). Among 870 535 Medicare patients, 3.2% (N=27 919) had a clinical diagnosis of NAFLD. Patients with NAFLD were more commonly women, were less commonly Black patients, and had a higher burden of comorbidities, such as diabetes, obesity, and kidney disease. Over a mean 14.3 months of follow-up, patients with (versus without) baseline NAFLD had a significantly higher risk of new-onset HF in unadjusted (6.4% versus 5.0%; P<0.001) and adjusted (adjusted hazard ratio [HR] [95% CI], 1.23 [1.18-1.29]) analyses. Among HF subtypes, the association of NAFLD with downstream risk of HF was stronger for HF with preserved ejection fraction (adjusted HR [95% CI], 1.24 [1.14-1.34]) compared with HF with reduced ejection fraction (adjusted HR [95% CI], 1.09 [0.98-1.2]). Conclusions Patients with NAFLD are at an increased risk of incident HF, with a higher risk of developing HF with preserved ejection fraction versus HF with reduced ejection fraction. The persistence of an increased risk after adjustment for clinical and demographic factors suggests an epidemiological link between NAFLD and HF beyond the basis of shared risk factors that requires further investigation.

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Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

November 16, 2021

Volume

10

Issue

22

Start / End Page

e021654

Location

England

Related Subject Headings

  • United States
  • Stroke Volume
  • Risk Factors
  • Retrospective Studies
  • Non-alcoholic Fatty Liver Disease
  • Medicare
  • Humans
  • Heart Failure
  • Female
  • Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Fudim, M., Zhong, L., Patel, K. V., Khera, R., Abdelmalek, M. F., Diehl, A. M., … Pandey, A. (2021). Nonalcoholic Fatty Liver Disease and Risk of Heart Failure Among Medicare Beneficiaries. J Am Heart Assoc, 10(22), e021654. https://doi.org/10.1161/JAHA.121.021654
Fudim, Marat, Lin Zhong, Kershaw V. Patel, Rohan Khera, Manal F. Abdelmalek, Anna Mae Diehl, Robert W. McGarrah, et al. “Nonalcoholic Fatty Liver Disease and Risk of Heart Failure Among Medicare Beneficiaries.J Am Heart Assoc 10, no. 22 (November 16, 2021): e021654. https://doi.org/10.1161/JAHA.121.021654.
Fudim M, Zhong L, Patel KV, Khera R, Abdelmalek MF, Diehl AM, et al. Nonalcoholic Fatty Liver Disease and Risk of Heart Failure Among Medicare Beneficiaries. J Am Heart Assoc. 2021 Nov 16;10(22):e021654.
Fudim, Marat, et al. “Nonalcoholic Fatty Liver Disease and Risk of Heart Failure Among Medicare Beneficiaries.J Am Heart Assoc, vol. 10, no. 22, Nov. 2021, p. e021654. Pubmed, doi:10.1161/JAHA.121.021654.
Fudim M, Zhong L, Patel KV, Khera R, Abdelmalek MF, Diehl AM, McGarrah RW, Molinger J, Moylan CA, Rao VN, Wegermann K, Neeland IJ, Halm EA, Das SR, Pandey A. Nonalcoholic Fatty Liver Disease and Risk of Heart Failure Among Medicare Beneficiaries. J Am Heart Assoc. 2021 Nov 16;10(22):e021654.
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

November 16, 2021

Volume

10

Issue

22

Start / End Page

e021654

Location

England

Related Subject Headings

  • United States
  • Stroke Volume
  • Risk Factors
  • Retrospective Studies
  • Non-alcoholic Fatty Liver Disease
  • Medicare
  • Humans
  • Heart Failure
  • Female
  • Aged