Cardiovascular disease (CVD) is the leading cause of death among individuals with non-alcoholic fatty liver disease (NAFLD), and a growing body of evidence indicates that NAFLD is strongly associated with an increased risk of incident CVD events.(1) The independent contribution of NAFLD to CVD development, however, remains an area of debate. Recently, Alexander et al. performed a population-based, retrospective, case-control study using data from four large European electronic primary care databases (United Kingdom, Netherlands, Italy and Spain) to estimate the incidence of fatal and non-fatal acute myocardial infarction (AMI) and ischemic/unspecified stroke in patients with NAFLD compared to the general population after adjustment for traditional CVD risk factors.(2) Among nearly 17.7 million individuals, 120,795 adults had a recorded diagnosis of NAFLD or non-alcoholic steatohepatitis (NASH) without other known liver diseases, a diagnosis of excessive alcohol use, or prior AMI or stroke. Cases were matched with up to 100 controls by age, sex, practice site, and visit within six months of the case’s NAFLD/NASH diagnosis. Participants were followed until the occurrence of a primary outcome, end of the study period, or database exit, and the median follow-up time was 2.1-5.5 years (with a total of 205,046 recorded diagnoses of CVD events that occurred during follow-up). Cox proportional hazards models estimated the hazard ratios (HR) of AMI and stroke within each database and then pooled HR using a random effect meta-analysis.

Is Nonalcoholic Fatty Liver Disease Not a Risk Factor for Cardiovascular Disease: Not Yet Time for a Change of Heart

Targher, Giovanni
Writing – Original Draft Preparation
;
2020-01-01

Abstract

Cardiovascular disease (CVD) is the leading cause of death among individuals with non-alcoholic fatty liver disease (NAFLD), and a growing body of evidence indicates that NAFLD is strongly associated with an increased risk of incident CVD events.(1) The independent contribution of NAFLD to CVD development, however, remains an area of debate. Recently, Alexander et al. performed a population-based, retrospective, case-control study using data from four large European electronic primary care databases (United Kingdom, Netherlands, Italy and Spain) to estimate the incidence of fatal and non-fatal acute myocardial infarction (AMI) and ischemic/unspecified stroke in patients with NAFLD compared to the general population after adjustment for traditional CVD risk factors.(2) Among nearly 17.7 million individuals, 120,795 adults had a recorded diagnosis of NAFLD or non-alcoholic steatohepatitis (NASH) without other known liver diseases, a diagnosis of excessive alcohol use, or prior AMI or stroke. Cases were matched with up to 100 controls by age, sex, practice site, and visit within six months of the case’s NAFLD/NASH diagnosis. Participants were followed until the occurrence of a primary outcome, end of the study period, or database exit, and the median follow-up time was 2.1-5.5 years (with a total of 205,046 recorded diagnoses of CVD events that occurred during follow-up). Cox proportional hazards models estimated the hazard ratios (HR) of AMI and stroke within each database and then pooled HR using a random effect meta-analysis.
2020
NAFLD; CVD risk
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/1017234
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