Abstract P324: Cardiovascular Risk and Mortality Increase with Progression of Chronic Liver Disease

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Introduction: Patients with c hronic liver disease accounts for 30-45% of the adult population in North America; among them, more die from cardiovascular disease (CVD) than from liver cirrhosis. Reduction of CVD-mortality in this high risk population requires understanding of CVD-risk across the whole spectrum of liver disease progression ranging from mild forms (i.e. nonalcoholic fatty liver disease) to advanced forms (i.e. nonalcoholic- and alcoholic-liver cirrhosis) as well as understanding of the increase of CVD-risks by time. Hypothesis: We assessed two hypotheses that (1) CVD-risk and mortality are dependent on type of liver disease; and that (2) CVD-risk and mortality increase in five years in all three types of chronic liver disease. One exploratory hypothesis was (3) the increment of CVD-risk in five years is higher in advanced forms than in a mild form of chronic liver disease. Methods: A secondary data analysis was conducted using 2,765 records of patients with nonalcoholic fatty liver disease, nonalcoholic- and alcoholic-liver cirrhosis identified by the International Classification of Disease -9 codes. Framingham risk scores were calculated for each patient based on their sex, age, systolic blood pressure, total cholesterol and high density lipoprotein level or body mass index, smoking status, and the presence of diabetes with five year interval from 2009 to 2014. Results: Framingham CVD risk scores were significantly different among patients of nonalcoholic fatty liver disease (21.4%), nonalcoholic- (21.3%) and alcoholic-liver cirrhosis (28.1%) ( F =5.610, p= .004). The all-cause mortality rate was significantly different among nonalcoholic fatty liver disease (5.8%), nonalcoholic- (20.5%) and alcoholic-liver cirrhosis (23.4%) ( [[Unsupported Character - Symbol Font ]] 2 =101.54, p =.000). In five years, CVD risk increased from 22.9 to 28.4% ( F =55.7, p =.000) with the greater extent in alcoholic- and nonalcoholic liver cirrhosis (increased by 7.2 and 6.0%, respectively) than in nonalcoholic fatty liver disease (increased by 3.4%) ( F =5.21, p =.023). Conclusions: We conclude that cardiovascular risks and mortality increase are dependent on type of liver disease. We also conclude that CVD risk increases in 5 years with the greater extent in advanced forms than in a mild form of chronic liver disease. To prevent CVD mortality, tailored risk reduction in earlier phases of chronic liver disease is crucial and may offer better outcomes.