Abstract 4366267: Hospitalizations for Metabolic Dysfunction-Associated Steatotic Liver Disease Among Patients with Different Cardiovascular Disease

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of chronic liver disease. Despite its rising burden, MASLD prevalence is likely underestimated, especially alongside cardiovascular disease (CVD). Although CVD is the leading cause of death in MASLD patients, hospitalization and mortality trends by CVD status are unclear. Research Questions: To assess trends in MASLD hospitalizations from 2008 to 2022 by CVD status and subtypes, and to examine demographic patterns and mortality using national inpatient data. Methods/Approach: National Inpatient Sample (NIS) data from 2008–2022 were analyzed. MASLD and CVD diagnoses (coronary artery disease, myocardial infarction, stroke, congestive heart failure, angina) were identified via ICD-9/10 codes. Survey-weighted Cochran-Armitage trend tests, linear regressions, chi-square tests, and descriptive statistics were performed by CVD status. Results/Data: Results/Data: Results/Data: Results/Data: MASLD admissions rose substantially between 2008 and 2022. Without CVD, admissions increased ~4-fold (175,000 to 703,000); with CVD, 6.3-fold (33,000 to 206,000). Annual admissions grew by 37,520 (95% CI: 32,013-43,027; R 2 0.943, p <0.01) without CVD and 12,023 (95% CI: 10,231-13,815; R 2 0.942, p<0.01) with CVD. In-hospital deaths increased by 997/year (95% CI: 688 -1,306; R 2 0.789, p<0.01) without CVD and 477/year (95% CI: 351 - 603; R 2 0.837, p<0.01) with CVD. Cochran-Armitage tests supported these trends (Z = -36.6, -5.4; p<0.01). In 2022, patients without CVD were mostly female (56.7%), aged 31- 64 (68.0%), White (66.4%), and resided mainly in the South (39.3%). Those with CVD were mostly male (51.7%), aged >64 (52.3%), White (74.2%), and mainly in the South (40.5%). Mortality was higher with CVD (4.05%) than without (2.45%, p<0.01). All demographic differences were significant (p<0.001). Between 2022, odds increased for myocardial infarction (6.9%, OR=1.069), congestive heart failure (5.1%, OR=1.05), coronary artery disease (2.6%, OR=1.03), stroke (1.4%, OR=1.01), and decreased for angina (18.1%, OR=0.82). Conclusion(s): MASLD hospitalizations have surged over 15 years, with mortality disproportionately higher among patients with CVD in 2022. Distinct demographic patterns reveal disparities in risk and outcomes, emphasizing the need for integrated liver-cardiovascular care, improved comorbidity screening, and targeted public health efforts to curb the rising MASLD burden.