Non-alcoholic fatty liver disease is associated with a worse prognosis in patients with heart failure: A pool analysis

Abstract

Background and aimsNon-alcoholic fatty liver disease (NAFLD) is associated with a higher risk of heart failure (HF) than those without NAFLD. However, the prognostic impact of NAFLD in HF is still controversial. This meta-analysis aimed to explore the association between NAFLD and the risk of adverse outcomes in patients with HF.MethodsWe searched multiple electronic databases (Embase, PubMed, and Google Scholar) for potentially related studies up to June 30, 2022. Cohort studies reported multivariable adjusted relative risks and 95% confidence intervals (CIs) of adverse outcomes in HF patients with NAFLD comparing those without NAFLD were included for analysis.ResultsA total of six studies involving 12,374 patients with HF were included for analysis, with a median follow-up duration of 2.5 years. The pooled analysis showed that HF patients with NAFLD were associated with a significantly increased risk of major composite adverse outcomes (HR 1.61, 95% CI 1.25-2.07), all-cause mortality (HR 1.66, 95% CI 1.39-1.98), and HF hospitalization or re-hospitalization (HR 1.71, 95% CI 1.03-2.86).ConclusionNAFLD is associated with a worse prognosis in patients with HF. Effective screening and treatment strategies are needed to improve the prognosis in HF patients with NAFLD.

The Cardiac-Kidney-Liver (CKL) syndrome: the “real entity” of type 2 diabetes mellitus

“…Briefly, in a previous retrospective cohort study including 870,535 Medicare beneficiaries, followed-up for a mean of 14.3 months, NAFLD patients had a significantly higher risk of new-onset HF (adjusted HR = 1.23, 95% CI: 1.18–1.29; p < 0.001), the risk being greater in relation to HFpEF (HR = 1.24, 95% CI: 1.14–1.34; p < 0.001) vs. HFrEF (HR 1.09, 95% CI: 0.98–1.2; p = 0.12) [ 68 ]. Of note, a recent meta-analysis including 6 studies with 12,374 HF patients, followed-up for a median of 2.5 years, reported that the presence of NAFLD significantly increased the risk of major adverse outcomes (HR = 1.61, 95% CI: 1.25–2.07), all-cause death (HR = 1.66, 95% CI: 1.39–1.98) and HF (re)hospitalization (HR = 1.71, 95% CI: 1.03–2.86) [ 69 ]. These findings highlight the impact of NAFLD, not only on HF development, but also on worse HF prognosis.…”

Non-alcoholic fatty liver disease and risk of cardiovascular diseases: clinical association, pathophysiological mechanisms, and management

“…(2022) [13] Ultrasound Meta-analysis (38 studies) (2022) [14] Ultrasound Meta-analysis (6 studies) [15] Ultrasound Meta-analysis (6 studies) (2018) [16] Ultrasound Systematic review and metaanalysis (12 studies) (2017) [17] Ultrasound Meta-analysis (3 studies) (2022) [18] Ultrasound Systematic review and metaanalysis (4 studies)…”

“…In a meta-analysis of six studies involving 12,374 HF patients, NAFLD was associated with higher risk of major composite adverse outcomes (i.e. myocardial infarction, stroke, or cardiovascular death) (HR: 1.61, 95% CI: 1.25-2.07), all-cause mortality (HR: 1.66, 95% CI: 1.39-1.98), and HF hospitalization or re-hospitalization (HR: 1.71, 95% CI: 1.03-2.86) [15] .…”