Non-Alcoholic Fatty Liver Disease (NAFLD) is associated with insulin resistance, type 2 diabetes (T2DM) and cardiovascular disease. However, data on NAFLD in patients with established cardiovascular disease (CVD) are scarce.

Here, we therefore aimed at investigating the association of NAFLD with T2DM as well as its impact on the incidence of major cardiovascular events (MACE) in a large series of 1517 patients with established CVD (1199 patients with angiographically proven coronary artery disease and 318 patients with sonographically proven peripheral artery disease) , using the validated fatty liver index for the diagnosis of NAFLD.

At baseline, the prevalence of NAFLD was significantly higher in patients with T2DM than in non-diabetic subjects (61.3% vs. 39.8%; p<0.001) respectively. Prospectively, we recorded 498 MACE over a mean follow-up period of 10.0±4.5 years. The risk of MACE was higher in NAFLD patients than in those who did not have NAFLD (49.5 vs. 43.5%; p=0.020) and in patients with T2DM than in non-diabetic subjects (41.4 vs. 28.1%; p<0.001) . Cox regression models adjusting for conventional cardiovascular risk factors proved NAFLD and T2DM to be mutually independent predictors of MACE, with adjusted hazard ratios of 1.34 [1.06-1.69] p=0.013 and 1.59 [1.32-1.92]; p<0.001, respectively.

We conclude that NAFLD and T2DM are mutually independent predictors of MACE in patients with established CVD.


L.Sprenger: None. M.Maechler: None. A.Vonbank: None. B.Larcher: None. A.Mader: None. A.Leiherer: None. A.Muendlein: None. H.Drexel: None. C.H.Saely: None.

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