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BACKGROUNDNon-alcoholic fatty liver disease (NAFLD) is a systemic disease with bidirectionalrelationships with cardiovascular disease (CVD). Non-alcoholic steatohepatitis(NASH) is a more severe subtype of NAFLD. Patients with NASH exhibit moreintra and extrahepatic inflammation, procoagulant imbalances andproatherogenic lipid profiles. Whether NASH increases the risk of ischemic heartdisease is currently unclear.AIMTo investigate the relationship between acute myocardial infarction (MI) andNASH in a large cohort of subjects in the United States.METHODSWe reviewed data from a large commercial database (Explorys IBM) thataggregates electronic health records from 26 large nationwide healthcare systems.Using systemized nomenclature of clinical medical terms (SNOMED CT), weidentified adult with the diagnosis of NASH from 1999-2019. We includedpatients with the diagnosis of acute MI from 2018-2019. Comorbidities known tobe associated with NASH and MI such as obesity, diabetes mellitus,hyperlipidemia, smoking, male gender, and hypertension were collected.Univariable and multivariable analyses were performed to investigate whetherNASH is independently associated with the risk of MI.RESULTSOut of 55099280 patients, 43170 were diagnosed with NASH (0.08%) and 107000(0.194%) had a MI within 2018-2019. After adjusting for traditional risk factors,NASH conferred greater odds of MI odds ratio (OR) 1.5 [95% confidence interval(CI): 1.40-1.62]. Hyperlipidemia had the strongest association with MI OR 8.39(95%CI: 8.21-8.58) followed by hypertension OR 3.11 (95%CI: 3.05-3.17) andsmoking OR 2.83 (95%CI: 2.79-2.87). NASH had a similar association with MI asthe following traditional risk factors like age above 65 years OR 1.47 (95%CI: 1.45-1.49), male gender OR 1.53 (95%CI: 1.51-1.55) diabetes mellitus OR 1.89 (95%CI:1.86-1.91).CONCLUSIONMI appears to be a prevalent disease in NASH. Patients with NASH may needearly identification and aggressive cardiovascular risk modification.
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篇名 Non-alcoholic steatohepatitis and the risk of myocardial infarction: Apopulation-based national study
来源期刊 世界肝病学杂志:英文版(电子版) 学科 医学
关键词 Non-alcoholic steatohepatitis Myocardial infarction Non-alcoholic fatty liver disease Ischemic cardiovascular disease United States population ATHEROSCLEROSIS
年,卷(期) 2020,(7) 所属期刊栏目
研究方向 页码范围 378-388
页数 11页 分类号 R57
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Non-alcoholic
steatohepatitis
Myocardial
infarction
Non-alcoholic
fatty
liver
disease
Ischemic
cardiovascular
disease
United
States
population
ATHEROSCLEROSIS
研究起点
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研究分支
研究去脉
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世界肝病学杂志:英文版(电子版)
月刊
1948-5182
北京市朝阳区东四环中路62号楼远洋国际中
出版文献量(篇)
381
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0
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0
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