Fatty liver increases risk for cardiovascular events in women
WASHINGTON — Women with nonalcoholic fatty liver disease saw significantly higher rates of subsequent cardiovascular events compared with men and saw them occur at a younger age, according to a speaker at The Liver Meeting 2017.
“Sex is such an important risk modifier that it’s included in all the calculators we use in daily practice to estimate someone’s risk of developing future cardiovascular events,” Alina M. Allen, MD, from the department of gastroenterology and hepatology at the Mayo Clinic, Rochester, Minn., said during a press conference. “It is known that in the general population, the female sex is protective for cardiovascular disease, which means that women are less likely than men to have cardiovascular events. What we found in this study is that this does not hold true in people who have NAFLD; we found that women with NAFLD are not more protected than men with NAFLD.”
Allen and colleagues culled 3,869 patients with NAFLD from the Rochester Epidemiology Project database and 15, 209 controls. Mean patient age was 53 years, 52% were women, and median follow-up was 7 years (range, 1-21 years).
The researchers identified 1,375 cardiovascular events. The protective effect of female sex on cardiovascular events (myocardial infarction, angina, congestive heart failure, stroke and atrial fibrillation) decreased from 26% in the controls (HR = 0.74; 95% CI, 0.66-0.84) to 8% in the patients with NAFLD (HR = 0.92; 95% CI, 0.76-1.10), even when all other cardiovascular risk factors, such as diabetes, hypertension, dyslipidemia, smoking and BMI are equal.
According to Allen, cardiovascular events occurred at a younger age among the women with NAFLD. As an example, Allen advised that a woman with NAFLD aged 50 years have a similar rate of cardiovascular events as a man aged 58 years and a woman aged 67 years from the general population controls.
Allen recommended reevaluating the impact of female sex to risk stratification calculation, stating that it is one of the next steps that need to be followed in treating and managing NAFLD.
“This is a signal that we found that we need to follow prospectively and see if this risk calculation really needs to be modified for people with NAFLD.” – by Talitha Bennett
Allen AM, et al. Abstract 55. Presented at: The Liver Meeting; Oct. 20-24, 2017; Washington, D.C.
Disclosure: Allen reports no relevant financial disclosures.Editor's note: This item has been updated to reflect the most recent data.