Ravi Patel, MD, Roopeessh Vempati, MD, Rakshana Ravichandran, MD, Aditya Kohli, MD, Devanshi Bhatt, MD, Yash Shah, MD, Quang Dat Ha, MD, Bhavin Patel, MD, Geetha Krishnamoorthy, MD Trinity Health Oakland Hospital, Pontiac, MI Introduction: Nonalcoholic fatty liver disease (NAFLD) is a spectrum of liver injury that can lead to cirrhosis & carcinoma, is closely linked to metabolic syndrome & dysregulated cytokine secretion, increasing the risk of atherosclerotic cardiovascular disease (ASCVD). NAFLD can independently contribute to CV mortality. This study analyzed NAFLD-related cardiovascular mortality (NAFLD-CVM) using a national death certificate database. Methods: The CDC-WONDER (1999–2023) was queried for NAFLD-CVM in individuals aged > 25 using ICD-10 codes. Age-adjusted mortality rates (AAMR) per 1,000,000 were analyzed. Annual percentage change (APC) & average annual percentage change (AAPC) were calculated using Joinpoint regression. An autoregressive integrated moving average model projected death through 2030. Results: In 1999, there were 606 NAFLD-CVM deaths (CDR:3.4), rising to 1294 in 2023(CDR:5.6). Projections estimate 1791 deaths by 2030 (95% CI: 1201–2382; CDR:7.4, 95% CI: 4.7–10.2). Among males, AAMR declined until 2014(APC: – 2.12), then rose (APC:6.5), with an AAPC of 1.03(p=0.01). Females had a modest rise until 2015 (APC:1.27), followed by a sharp increase (APC:10.08), resulting in an AAPC of 4.13(p< 0.001). In White Americans (WA), AAMR declined slightly until 2014, then rose (APC:7.48), producing an AAPC of 2.49(p< 0.001). African Americans (AA) showed a decline until 2014 (APC: – 4.82), followed by a reversal (APC:9.13), with an overall AAPC of 0.19(p=0.69). WA males declined through 2014 (APC: – 1.59), then increased (APC: 6.57), with an AAPC of 1.39 (p=0.01). AA males dropped from 1999–2012 (APC: – 6.7), then rose (APC:6.85), but the AAPC remained non-significant (– 0.71, p=0.29). WA females had a non-significant rise until 2014(APC:1.56), followed by a marked increase (APC:10.37), leading to an AAPC of 4.78(p< 0.001). AA females declined until 2016(APC: – 2.38), then rose (APC:9.72), with an AAPC of 1.01(p=0.22). Regionally, the Northeast showed a non-significant AAPC (0.18, p=0.54). The Midwest showed steady growth, with a sharp rise from 2009(APC:8.17), and an AAPC of 4.73 (p< 0.001). The South and West initially declined, then rose significantly, with AAPCs of 3.1(p< 0.001) and – 0.89 (p=0.01), respectively. Discussion: NAFLD-CVM is increasing & projected to rise further in the U.S. AAMR is rising most notably among females, especially WA females with significant regional increases in the Midwest, South & West. NAFLD screening should be integrated into cardiometabolic risk assessment strategies.
Figure: Joinpoint Regression Analysis of Cardiovascular Mortality Attributable to Non-alcoholic Fatty Liver Disease with Results Table
Disclosures: Ravi Patel indicated no relevant financial relationships. Roopeessh Vempati indicated no relevant financial relationships. Rakshana Ravichandran indicated no relevant financial relationships. Aditya Kohli indicated no relevant financial relationships. Devanshi Bhatt indicated no relevant financial relationships. Yash Shah indicated no relevant financial relationships. Quang Dat Ha indicated no relevant financial relationships. Bhavin Patel indicated no relevant financial relationships. Geetha Krishnamoorthy indicated no relevant financial relationships.
Ravi Patel, MD, Roopeessh Vempati, MD, Rakshana Ravichandran, MD, Aditya Kohli, MD, Devanshi Bhatt, MD, Yash Shah, MD, Quang Dat Ha, MD, Bhavin Patel, MD, Geetha Krishnamoorthy, MD. P3755 - Rising Cardiovascular Mortality Due to Non-Alcoholic Fatty Liver Disease: Trends, Disparities and Projections Using the CDC-WONDER Database, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
