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Optimising the management of cardiovascular comorbidities in NAFLD patients: it’s time to (re-) act!
  1. Philipp Kasper1,
  2. Sonja Lang1,
  3. Muenevver Demir2,
  4. Hans-Michael Steffen1
  1. 1 Clinic for Gastroenterology and Hepatology, University Hospital Cologne, Köln, Nordrhein-Westfalen, Germany
  2. 2 Department of Hepatology and Gastroenterology, Charité University Medicine, Campus Virchow Clinic and Campus Charité Mitte, Charite Universitatsmedizin Berlin, Berlin, Germany
  1. Correspondence to Professor Hans-Michael Steffen, Clinic for Gastroenterology and Hepatology, University Hospital Cologne, Köln, Nordrhein-Westfalen 50924, Germany; hans-michael.steffen{at}

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With great interest, we have read the recent article by Simon et al,1 reporting a significant association between non-alcoholic fatty liver disease (NAFLD) and incident major adverse cardiovascular events.

The authors found that patients with biopsy-proven NAFLD had a significantly higher incidence of ischaemic heart disease, stroke, congestive heart failure and death due to cardiovascular disease (CVD), when compared with matched controls. An excess in CVD morbidity and mortality was evident across all stages of NAFLD and increased with worsening disease severity.

The authors are to be congratulated for conducting such a large population-based retrospective cohort study including data of more than 10 000 patients with histologically confirmed NAFLD free of pre-existing CVD at baseline followed over a very long observation period of 13.6 years.

The findings are in line with several recently published studies and provide further evidence that NAFLD might be an independent risk …

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  • Contributors PK, SL, MD and HMS wrote the manuscript and reviewed the literature.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; internally peer reviewed.