Abstract 16380: Does Non-Alcoholic Fatty Liver Disease Increase the Risk of Ventricular Arrhythmias in Patients With Heart Failure?

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD), including non-alcoholic fatty liver and non-alcoholic fatty steatohepatitis, is associated with increased incidence of heart failure (HF). Previous studies have shown an association of NAFLD with increased incidence of ventricular arrhythmias (VAs). however, it is unknown if the increased rate of VA is related to increased HF or if from an independent NAFLD-related mechanism. Therefore, this study aimed to investigate the effect of NAFLD on VA in patients with HF. Methods: A retrospective cohort study of electronic heath records using the TriNetX Research Network was performed. Patients at least 18 years old with diagnosis of cardiomyopathy (CM) or HF were identified by ICD-10-CM codes from January 1, 2014 to December, 31, 2019. Patients were separated based on the diagnosis of NAFLD. Patients who had HF and NAFLD were propensity-score matched (PSM) using age, sex, race, hypertension, hyperlipidemia, ischemic heart disease, cerebrovascular disease, atherosclerosis, diabetes mellitus, acute or chronic kidney disease, acute or chronic respiratory failure, anemia, atrial fibrillation/atrial flutter, body mass index, corrected QT interval, presence of implantable cardioverter-defibrillator, and medications with patients with HF alone. The primary outcomes were 3-year all-cause mortality, hospital admission, and incident VAs. Results: After PSM, 50,969 pairs were analyzed. NAFLD diagnosis was associated with significantly higher odds of VA (odds ratio [OR] 2.75, 95% confidence interval [CI] 2.54-2.98, p <0.0001) and hospital admission (OR 1.05, CI 1.03-1.08, p <0.0001) at 3-years. No significant difference was observed in mortality (OR 0.98, 95% CI 0.95-1.01, p =0.10). Conclusion: Patients with HF diagnosed with NAFLD had significantly higher odds of VA and hospital admission but not mortality at 3-years. Future studies are needed to evaluate mechanisms of VA in NAFLD patients.