title: Nonalcoholic Fatty Liver Disease Is Associated With Higher 1-year All-Cause Rehospitalization Rates in Patients Admitted for Acute Heart Failure.
abstract: Repeat hospitalization due to acute heart failure (HF) is a global public health problem that markedly impacts on health resource use. Identifying novel predictors of rehospitalization would help physicians to determine the optimal postdischarge plan for preventing HF rehospitalization. Nonalcoholic fatty liver disease (NAFLD) is an emerging risk factor for many heart diseases, including HF. We assessed whether NAFLD at hospital admission predicts 1-year all-cause rehospitalization in patients with acute HF. We enrolled all patients consecutively admitted for acute HF to our General Medicine Division, from January 2013 to April 2014, after excluding patients with acute myocardial infarction, severe heart valve diseases, malignancy, known liver diseases, and those with volume overload related to extracardiac causes. NAFLD was diagnosed by ultrasonography and exclusion of competing etiologies. The primary outcome of the study was the 1-year all-cause rehospitalization rate. Among the 107 patients enrolled in the study, the cumulative rehospitalization rate was 12.1% at 1 month, 25.2% at 3 months, 29.9% at 6 months, and 38.3% at 1 year. Patients with NAFLD had markedly higher 1-year rehospitalization rates than those without NAFLD (58% vs 21% at 1 y; P < 0.001 by the log-rank test). Cox regression analysis revealed that NAFLD was associated with a 5.5-fold increased risk of rehospitalization (adjusted hazard ratio 5.56, 95% confidence interval 2.46-12.1, P < 0.001) after adjustment for multiple HF risk factors and potential confounders. In conclusion, NAFLD was independently associated with higher 1-year rehospitalization in patients hospitalized for acute HF.
authors.affiliation: From the Division of General Medicine "Sacro Cuore" Hospital, Negrar, VR, Italy (FV, CG, LS, GA); Division of Cardiology, "Sacro Cuore" Hospital, Negrar, VR, Italy (SB, AC); Section of Cardiology, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy (AR); Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy (GZ, GT); Internal Medicine and Outpatient Liver Clinic, NOCSAE Baggiovara, Azienda USL di Modena, Modena, Italy (AL); Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, UK (CDB); and NIHR Biomedical Research Centre, University of Southampton (CDB), Southampton, UK.
authors.forename: Filippo
authors.initials: F
authors.lastname: Valbusa
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonapace
authors.forename: Cristina
authors.initials: C
authors.lastname: Grillo
authors.forename: Luca
authors.initials: L
authors.lastname: Scala
authors.forename: Andrea
authors.initials: A
authors.lastname: Chiampan
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossi
authors.forename: Giacomo
authors.initials: G
authors.lastname: Zoppini
authors.forename: Amedeo
authors.initials: A
authors.lastname: Lonardo
authors.forename: Guido
authors.initials: G
authors.lastname: Arcaro
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Byrne
authors.forename: Giovanni
authors.initials: G
authors.lastname: Targher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011446:Prospective Studies