P3643 - Sex Disparities, Trends, and Factors Associated With Cardiovascular Outcomes in Metabolic Associated Steatotic Liver Disease

Ihunanya M. Kanu, MBBS, MPH¹, Efeturi M. Okorigba, MBBS², Fidelis E. Uwumiro, MD³, Bright Nwatamole, MD⁴, Uduakobong Essien, MD³, Adetayo Ajiboye, MD⁵, Frankly G. Ojeh, MD⁶, Ifeyinwa Ezeudu, MD⁷, Chidera Chukwuneta, MD⁸, Babajide Komolafe, MD⁹, Onyinye Ebiliekwe, MD¹⁰, Christian Offiah, MBBS¹¹, Ezinne Onwuatuegwu, MD¹², Adetokunbo Adesina, MD¹³
1Baptist Memorial Hospital-Golden Triangle, Columbus, MS; 2West Virginia University · Morgantown, USA, Morgantown, WV; 3Southern Regional Medical Center · Riverdale, Georgia, USA, Riverdale, GA; 4Nuvance Health Vassar Brothers Medical Center · Poughkeepsie, USA, Poughkeepsie, NY; 5Birmingham and solihull NHS · Birmingham, GBR, Birmingham, England, United Kingdom; 6Ebonyi state university. · Abakaliki , NGA, Abakaliki, Ebonyi, Nigeria; 7Autism Support and Services · Alberta, CA, Alberta, CA; 8Chukwuemeka Odumegwu Ojukwu University College of Medical Sciences · Anambra, NGA, Anambra, Anambra, Nigeria; 9College of Medicine, University of Lagos · Lagos, NGA, Lagos, Lagos, Nigeria; 10Nnamdi Azikiwe University Teaching Hospital · Nnewi, NGA, Nnewi, Anambra, Nigeria; 11Chukwuemeka Odumegwu Ojukwu University College of Medical Sciences · Awka, NGA, Awka, Anambra, Nigeria; 12College of Medicine, University of Nigeria · Nsukka, NER, Nsukka, Enugu, Nigeria; 13Buckinghamshire Healthcare NHS Trust · Aylesbury, GBR, Buckinghamshire, England, United Kingdom

Introduction: Major adverse cardiovascular events (MACEs) are contributors to morbidity in patients with liver disease. Limited data exist on cardiovascular outcomes among patients with MASLD. We analyzed the national trends, predictors, and sex disparities in the incidence of MACEs among patients with MASLD in the United States from 2016 to 2021.

Methods: We retrospectively analyzed the 2016-2021 National Inpatient Sample database. Hospitalizations for MASLD were identified using ICD-10 codes, and outcomes, including MACEs, inpatient mortality, and comorbidities, were assessed. Multivariate regression was used to determine the predictors of MACEs. Trends in MACE incidence were analyzed using weighted national estimates and Cuzick’s trend tests.

Results: A total of 31,975 hospitalizations for MASLD were analyzed, comprising 19,730 women (61.7%) and 12,246 men (38.3%). The incidence of MACEs was 8.9% (2,846), with a higher rate in men (1,185, 9.7%) than in women (1,660, 8.4%). Acute heart failure was the most frequent type of MACE (1,390; 4.3%). Predictors of MACEs included a higher baseline mortality risk (AOR: 3.41, P < 0.001), congestive heart failure (AOR: 4.81, P < 0.001), and previous ischemic stroke (AOR: 4.47, P < 0.001). From 2016 to 2021, the incidence of acute heart failure increased significantly (1,023 [3.2%] to 1,918 [6.0%], P<sub>trend < 0.001), while that of acute myocardial infarction decreased from 416 (1.3%) to 96 (0.3%) (Ptrend = 0.027). No significant trends were observed in acute ischemic stroke or in-hospital mortality.A total of 31,975 hospitalizations for MASLD were analyzed, comprising 19,730 women (61.7%) and 12,246 men (38.3%). The incidence of MACEs was 8.9% (2,846), with a higher rate in men (1,185, 9.7%) than in women (1,660, 8.4%). Acute heart failure was the most frequent type of MACE (1,390; 4.3%). Predictors of MACEs included a higher baseline mortality risk (AOR: 3.41, P < 0.001), congestive heart failure (AOR: 4.81, P < 0.001), and previous ischemic stroke (AOR: 4.47, P < 0.001). From 2016 to 2021, the incidence of acute heart failure increased significantly (1,023 [3.2%] to 1,918 [6.0%], P<sub>trend < 0.001), while that of acute myocardial infarction decreased from 416 (1.3%) to 96 (0.3%) (Ptrend = 0.027).

Discussion: Nearly 1 in 10 individuals with MASLD experienced a MACE with acute heart failure being most common and showing a significant uptrend over the study period. Previous ischemic stroke and coexisting congestive heart failure are important predictors of MACE.


Figure: Incidence of major adverse cardiovascular events in the total study cohort


Figure: Incidence of major adverse cardiovascular events in the male cohort
*Includes acute decompensation of chronic heart failure

MACE, major adverse cardiovascular events; MI, myocardial infarction

Disclosures:
Ihunanya Kanu indicated no relevant financial relationships.
Efeturi Okorigba indicated no relevant financial relationships.
Fidelis Uwumiro indicated no relevant financial relationships.
Bright Nwatamole indicated no relevant financial relationships.
Uduakobong Essien indicated no relevant financial relationships.
Adetayo Ajiboye indicated no relevant financial relationships.
Frankly Ojeh indicated no relevant financial relationships.
Ifeyinwa Ezeudu indicated no relevant financial relationships.
Chidera Chukwuneta indicated no relevant financial relationships.
Babajide Komolafe indicated no relevant financial relationships.
Onyinye Ebiliekwe indicated no relevant financial relationships.
Christian Offiah indicated no relevant financial relationships.
Ezinne Onwuatuegwu indicated no relevant financial relationships.
Adetokunbo Adesina indicated no relevant financial relationships.

Ihunanya M. Kanu, MBBS, MPH¹, Efeturi M. Okorigba, MBBS², Fidelis E. Uwumiro, MD³, Bright Nwatamole, MD⁴, Uduakobong Essien, MD³, Adetayo Ajiboye, MD⁵, Frankly G. Ojeh, MD⁶, Ifeyinwa Ezeudu, MD⁷, Chidera Chukwuneta, MD⁸, Babajide Komolafe, MD⁹, Onyinye Ebiliekwe, MD¹⁰, Christian Offiah, MBBS¹¹, Ezinne Onwuatuegwu, MD¹², Adetokunbo Adesina, MD¹³. P3643 - Sex Disparities, Trends, and Factors Associated With Cardiovascular Outcomes in Metabolic Associated Steatotic Liver Disease, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.