Abstract P587: Patients With Diabetes Mellitus and Atrial Fibrillation Affected by Non-Alcoholic Fatty Liver Disease Have Greater Risk of Mortality and Worse Clinical Outcomes

Background: Patients with diabetes mellitus (DM) are increasingly affected by AF. Non-Alcoholic Fatty Liver Disease (NAFLD) is an emerging disease and risk factor of interest that predisposes to adverse outcomes. Nevertheless, there is limited scientific evidence of clinical outcomes of NAFLD in patients with AF&DM. Therefore, we sought to investigate this population. Methods: We queried NIS between 2016-2019 for adult patients who were hospitalized with AF&DM and had NAFLD. The primary outcome was inpatient mortality. The secondary outcomes were cardiogenic shock, cardiac arrest, gastrointestinal bleeding (GIB), invasive mechanical ventilation, length of stay (LOS) and total hospital charge. Multivariable logistic and Poisson regression analyses were used to estimate clinical outcomes. P-value < 0.05 was significant. Results: There were 6,723,293 patients with AF&DM and 253,639 (3.7%) had NAFLD. NAFLD and non-NAFLD cohorts were with mean age of 70.4 vs. 73.8 yrs; males 57.2% vs 55.6%; Caucasians 70.5% vs 73.9%; HTN 20.3% vs 29.2%; HF 61.4% vs 56%; CKD 53.4% vs 45.2%; obese 26.9% vs 27.1%; dyslipidemia 49.8% vs 61.9%; anemia 24.8% vs 19.2%; history of MI 10.9% vs 13.3%; stroke 2.4% vs 4.1%, COPD 28.8% vs 31.1%; alcohol use 5.2% vs 2.2%, respectively. NAFLD cohort had significantly higher mortality and worse clinical outcomes (Table 1). Conclusion: AF&DM patients with NAFLD demonstrated significantly worse clinical outcomes and higher resource utilization. They were younger, with greater comorbid HF, anemia, CKD. Cardiogenic shock, cardiac arrest and GI bleed were all higher in the NAFLD subgroup. NAFLD may therefore raise the risk for ventricular dysfunction and coagulopathy. Awareness of this risk factor is essential in the AF&DM population. Further research is necessary to assess long-term outcomes.