Abstract 4364797: Trends in Nonalcoholic Steatohepatitis and Congestive Heart Failure Mortality in the United States from 1999 to 2020: A Comprehensive Analysis

Background: Metabolic-dysfunction associated steatohepatitis (MASH), previously nonalcoholic steatohepatitis (NASH), and congestive heart failure (CHF) are rising public health concerns in the U.S. This study evaluates trends in age-adjusted mortality rates (AAMR) for NASH and CHF from 1999 to 2020. Methods: CHF-related deaths in patients with pre-existing NASH from 1999 to 2020 were obtained from the CDC WONDER database. AAMR per million population were calculated. Trends were analyzed using average annual percentage change (AAPC) and joinpoint regression. Results: From 1999 to 2020, NASH and CHF caused 68,436 deaths in the U.S. AAMR increased from 12.49 per million (95% CI 11.97-13.01) in 1999 to 29.25 per million (95% CI 23.71-24.9) in 2020. Mortality rates declined from 1999 to 2010 (APC -1.49; 95% CI -2.23 to -0.89, p=0.003) but surged from 2017 to 2020 (APC 12.35; 95% CI 9.70-15.98, p=0.010). The overall AAPC was 3.05% (95% CI 2.79-3.30, p<0.0001). Conclusion: This analysis shows a concerning increase in NASH and CHF-related mortality in recent years. The rise in mortality highlights the need for targeted clinical interventions and public health strategies to mitigate the burden of these diseases.