Introduction:

Metabolic hepatic steatosis (MASLD: Metabolic dysfunction-associated steatotic liver disease) is an entity that includes fatty liver, steatohepatitis, fibrosis, cirrhosis and hepatic carcinoma. Its prevalence is increasing associated with the increase in diabetes mellitus 2 (DMT2) and obesity, being a public health problem worldwide. The prevalence of MASLD is 55.5%, 37.3% steatohepatitis, 17% hepatic fibrosis. It is also considered a comorbidity of heart failure (HF) with a bidirectional behavior due to the systemic involvement of both pathologies. There are noninvasive methods that can identify the risk of liver fibrosis such as the FIB-4 score. Studies have shown the benefit of empagliflozin in MASLD. This work aims to determine the prevalence of the risk of developing liver fibrosis using the FIB-4 score and evaluate the changes in the risk category one year after receiving said drug.

Methodology:

This subanalysis of the EMPUMIC study “use of empagliflozin in diabetic patients with heart failure with reduced ejection fraction (HFrEF)”. Retrospective, descriptive, observational study of the population included in the EMPUMIC study. The data were collected in Excel, the FIB-4 score was calculated, which has four variables such as age, transaminases (AST/ALT) and platelets.

Results:

31 patients (17 men) with a median age of 61 years were included. A significant decrease in transaminase levels was observed with treatment with empagliflozin (p: 0.015). 74.19% of patients before starting treatment with empagliflozin were at risk of liver fibrosis due to the FIB-4 score and one year after treatment with this drug, there was a significant reduction in risk (p: 0.049).

Conclusions:

A high risk of developing liver fibrosis was observed in patients with HF and DMT2. One-year treatment with empagliflozin showed a change in the risk category by the FIB-4 score and a decrease in transaminase levels. It is important to investigate this very prevalent comorbidity in order to carry out a timely intervention.

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