S1245 The Prevalence of Coronary Artery Diseases in Patients With Liver Cirrhosis

Introduction: Coronary Artery Disease (CAD) is one of the major cardiovascular diseases affecting the global human population. It remains the leading cause of death in the United States and worldwide. Liver cirrhosis (LC) is an increasing cause of mortality and morbidity in the developed countries and worldwide. Studies have shown conflicting data when it come to the cardiovascular risk in patients with liver cirrhosis. Some studies suggested a lower risk of CAD in patient with liver cirrhosis while other studies demonstrated higher prevalence of cardiovascular diseases in this patient’s population. We conducted this study to evaluate the association between Liver cirrhosis and Coronary Artery Diseases. Methods: Data was collected from a commercial database: Explorys Inc, IBM Watson. Charts of all adults older than 20 years, from March 2018 till March 2021, were reviewed. Patients with the diagnosis of "Cirrhosis of the Liver” (LC) based on Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) were included in the LC group and the rest were the control group. The prevalence of Coronary artery disease (CAD) was compared in both groups and statistical multivariate model was performed. Results: A total of 20,010,700 patients were included in the study; the LC group comprised of 10,170 patients. The overall prevalence of CAD was 77 in 1000 compared to 18 in 1000 in the non-LC group (P< 0.0001). In the multivariate analysis after adjusting for age, sex, race and common risk factors for CAD, the odds ratio (OR) for CAD 1.332 (95% CI; 1.304-1.361). The strongest predictor of CAD in the LC group was Dyslipidemia OR, 3.925 (95% CI; 3.664-4.204). Other predictors for CAD included Essential Hypertension [OR, 2.527 (95% CI; 2.325-2.746)], Type II Diabetes mellitus [OR, 1.679 (95% CI; 1.605-1.757)], Obesity, which was identified as BMI > 30, had an OR of 1.48 (95% CI; 1.415-1.548), smoking [OR, 1.401 (95% CI; 1.343-1.463)] and sex: Male vs Female [OR, 1.728 (95% CI; 1.655-1.805)]. For all the aforementioned predictors P value was < 0.0001. Conclusion: Patients with LC had higher prevalence of CAD compared to the non-LC patients. Likewise, the OR for CAD was higher in the LC. This study showed that patient with LC were more likely to have comorbidities that are considered to be a risk factor for CAD which could increase the risk of CAD in those patients. We need further prospective studies to determine the true association and the actual risk of CAD in patients with LC.Figure 1.: Creatinine Clearance over time. Treatment: Blue = entecavir; Gray - tenofovir alafenamide; Yellow - tenofovir disoproxil fumarate