P2917 - Gender and Racial Disparities in Cardiovascular Outcomes Among Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease and Comorbid Heart Failure with Preserved Ejection Fraction: a Nationwide Analysis

Natchaya Polpichai, MD¹, Sakditad Saowapa, MD², Amro Taha, MD¹, Phuuwadith Wattanachayakul, MD³, Pojsakorn Danpanichkul, MD², Aunchalee Jaroenlapnopparat, MD⁴, Alexandr Ceban, MD¹, Apichat Kaewdech, MD^5
1Weiss Memorial Hospital, Chicago, IL; ²Texas Tech University Health Sciences Center, Lubbock, TX; ³Einstein Healthcare Network, Philadelphia, PA; ⁴Mount Auburn Hospital/Harvard Medical School, Boston, MA; ⁵Prince of Songkla University, Hatyai, Songkhla, Thailand

Introduction: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Heart Failure with Preserved Ejection Fraction (HFpEF) are both linked with significant morbidity and mortality. This study aims to assess the impact of gender and racial differences on cardiovascular outcomes in patients concurrently diagnosed with MASLD and HFpEF.






Methods: A retrospective analysis of National Inpatient Sample (NIS) data from 2016 to 2020 identified adults with MASLD using the ICD-10 codes, and categorized them by the presence of HFpEF. The primary outcome was in-hospital mortalioty, while the secondary outcomes included cardiovascular outcomes such as cardiac arrest, acute myocardial infarction (AMI), and acute ischemic stroke (AIS). Multivariable logistic regression models were utilized to adjust for potential confounders and to assess the impact of gender and race on clinical outcomes between these cohorts, with p-values ≤ 0.05 indicating statistical significance. Males and Whites were used as the reference categories.

Results: The study cohort consisted of 1,847,790 patients with MASLD, 94,955 patients had HFpEF with a distribution of 57% females and 43% males. Racial composition was 73% white, 13% Black, 9% Hispanic, and 5% other races. After adjustment for confounders, females with MASLD and HFpEF exhibited significantly lower mortality with adjusted odds ratios (aOR = 0.88 [0.83, 0.93]), cardiac arrest (aOR = 0.68 [0.62, 0.75]), AMI (aOR = 0.72 [0.69, 0.76]), and AIS (aOR = 0.83 [0.77, 0.89]). Compared to White patients, Black and other races demonstrated a higher risk of mortality, with aORs of 1.12 [1.02, 1.23] and 1.21 [1.03, 1.42], respectively. Black patients also had a higher risk of cardiac arrest, with an aOR of 1.51 [1.32, 1.72]. In terms of AMI, Hispanic, Asian/Pacific Islander, and other races showed significantly higher odds compared to White patients. Additionally, Black patients faced a higher risk of AIS, with an aOR of 1.33 [1.19, 1.48]). All P-values were < 0.05.

Discussion: This study revealed significant gender and racial disparities in cardiovascular outcomes among patients with MASLD and HFpEF. Women with these conditions experienced notably better outcomes than men. Racial disparities were particularly pronounced, with Black and Hispanic patients facing higher risks compared to White patients, indicating a critical need for interventions and deeper exploration into the social determinants affecting health disparities.


Disclosures:


Natchaya Polpichai, MD¹, Sakditad Saowapa, MD², Amro Taha, MD¹, Phuuwadith Wattanachayakul, MD³, Pojsakorn Danpanichkul, MD², Aunchalee Jaroenlapnopparat, MD⁴, Alexandr Ceban, MD¹, Apichat Kaewdech, MD⁵. P2917 - Gender and Racial Disparities in Cardiovascular Outcomes Among Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease and Comorbid Heart Failure with Preserved Ejection Fraction: a Nationwide Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.