Non-alcoholic fatty liver disease and increased risk of all-cause mortality in elderly patients admitted for acute heart failure
| Autor: | Davide Agnoletti, Giovanni Targher, Pietro Arduini, Aldo P. Maggioni, Giuliana Scaturro, Filippo Valbusa, Giacomo Zoppini, Alessandro Mantovani, Stefano Calabria, Stefano Bonapace, Luca Scala, Cristina Grillo, Emanuela Turcato, Guido Arcaro |
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| Přispěvatelé: | Valbusa F., Agnoletti D., Scala L., Grillo C., Arduini P., Bonapace S., Calabria S., Scaturro G., Mantovani A., Zoppini G., Turcato E., Maggioni A.P., Arcaro G., Targher G. |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Cirrhosis 030204 cardiovascular system & hematology Follow-Up Studie Cohort Studies 03 medical and health sciences 0302 clinical medicine Patient Admission Non-alcoholic Fatty Liver Disease Risk Factors Internal medicine Acute heart failure Mortality NAFLD Non-alcoholic fatty liver disease Nonalcoholic fatty liver disease medicine Humans Cumulative incidence Prospective Studies Myocardial infarction Aged Aged 80 and over Heart Failure business.industry Proportional hazards model Fatty liver medicine.disease Prospective Studie Heart failure Etiology 030211 gastroenterology & hepatology Female Cohort Studie Cardiology and Cardiovascular Medicine business Follow-Up Studies Human |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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