Both Alcoholic and Non-Alcoholic Liver Cirrhosis Are Associated with an Increased Risk of HF — A Cohort Study Including 75,558 Patients
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MDPI
Abstract
The objective of the present study was to evaluate the association between liver cirrhosis
(LC) and subsequent Heart failure (HF). This retrospective cohort study utilized data from
the Disease Analyzer database (IQVIA) and included adults with a first-time diagnosis
of LC in 1293 general practices in Germany between January 2005 and December 2023.
A comparison cohort without liver diseases was matched to the cirrhosis group using
5:1 propensity score matching. Univariable Cox proportional hazards models were used
to assess the association between alcoholic vs. non-alcoholic LC and HF. The final study
cohort included 5530 patients with alcoholic LC and 27,650 matched patients without liver
disease, as well as 7063 patients with non-alcoholic LC and 35,315 matched patients without
liver disease. After up to 10 years of follow-up, HF was diagnosed in 20.9% of patients
with alcoholic LC compared to 10.3% of matched cohort, and in 23.0% of patients with
non-alcoholic LC, compared to 14.2% in matched cohort. Alcoholic LC (Hazard Ratio (HR):
2.07 (95% CI: 1.85–2.31) and non-alcoholic LC (HR: 1.70; 95% CI: 1.56–1.82) were associated
with an increased risk of HF. The association was also stronger in men than in women. LC,
both alcoholic and non-alcoholic, is significantly associated with an increased long-term
risk of HF. The association is particularly pronounced in patients with alcoholic cirrhosis
and in men. To the best of the authors’ knowledge, this is the first real-world evidence for
the positive association between LC and subsequent HF from Europe.
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