Non-alcoholic steatohepatitis and the risk of myocardial infarction: Apopulation-based national study

作     者：Sara Ghoneim Aneesh Dhorepatil Aun Raza Shah Ganesh Ram Subhan Ahmad Chang Kim Imad Asaad 

作者机构：Department of Internal MedicineCase Western Reserve University at MetroHealth Medical CenterClevelandOH 44109United States Department of Pain ManagementThe Schulich School of Medicine and DentistryLondonOntario N6A 5C1Canada Division of GastroenterologyCase Western Reserve University at MetroHealth Medical CenterClevelandOH 44109United States 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2020年第12卷第7期

页      面：378-388页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：We gratefully acknowledge Dr.Joseph Sudano for ensuring the data analysis is appropriate for this research 

主　　题：Non-alcoholic steatohepatitis Myocardial infarction Non-alcoholic fatty liver disease Ischemic cardiovascular disease United States population Atherosclerosis 

摘      要：BACKGROUNDNon-alcoholic fatty liver disease (NAFLD) is a systemic disease with bidirectionalrelationships with cardiovascular disease (CVD). Non-alcoholic steatohepatitis(NASH) is a more severe subtype of NAFLD. Patients with NASH exhibit moreintra and extrahepatic inflammation, procoagulant imbalances andproatherogenic lipid profiles. Whether NASH increases the risk of ischemic heartdisease is currently *** investigate the relationship between acute myocardial infarction (MI) andNASH in a large cohort of subjects in the United *** reviewed data from a large commercial database (Explorys IBM) thataggregates electronic health records from 26 large nationwide healthcare *** systemized nomenclature of clinical medical terms (SNOMED CT), weidentified adult with the diagnosis of NASH from 1999-2019. We includedpatients with the diagnosis of acute MI from 2018-2019. Comorbidities known tobe associated with NASH and MI such as obesity, diabetes mellitus,hyperlipidemia, smoking, male gender, and hypertension were *** and multivariable analyses were performed to investigate whetherNASH is independently associated with the risk of *** of 55099280 patients, 43170 were diagnosed with NASH (0.08%) and 107000(0.194%) had a MI within 2018-2019. After adjusting for traditional risk factors,NASH conferred greater odds of MI odds ratio (OR) 1.5 [95% confidence interval(CI): 1.40-1.62]. Hyperlipidemia had the strongest association with MI OR 8.39(95%CI: 8.21-8.58) followed by hypertension OR 3.11 (95%CI: 3.05-3.17) andsmoking OR 2.83 (95%CI: 2.79-2.87). NASH had a similar association with MI asthe following traditional risk factors like age above 65 years OR 1.47 (95%CI: 1.45-1.49), male gender OR 1.53 (95%CI: 1.51-1.55) diabetes mellitus OR 1.89 (95%CI:1.86-1.91).CONCLUSIONMI appears to be a prevalent disease in NASH. Patients with NASH may needearly identification and aggressive cardiovascular risk modification.