VA Research Wrap Up: New findings on suicide, liver disease and stroke

This week, VA’s Office of Research and Development published three News Briefs highlighting research findings on a suicide, liver disease and stroke.

Moral injury increases suicide thoughts and attempts

Central Arkansas VA and the National Center for PTSD led a national team of researchers who found Veterans, health care workers, and first responders who screened positive for moral injury had six-times greater odds of attempting suicide in their lifetime and were three times more likely to have thought of suicide in the last two weeks. The researchers surveyed a national sample of 1,200 men and women from high-stress, service-oriented military and civilian occupations. Within this group, 6% screened positive for probable moral injury. Moral injury can develop from exposure to a highly stressful event that goes against one’s beliefs about morally acceptable conduct The researchers found moral injury is significantly associated with suicidal thoughts and attempts after controlling for other factors such as mental illness, age, and sex. The findings demonstrate the importance of including moral injury in suicide prevention efforts, especially for people who work in high-stress, service-oriented occupations. View the full study from “njp Mental Health Research.”

GLP1-RA reduces risk of death in liver disease patients

Researchers from VA Orlando and the University of Florida reported Veterans with non-alcoholic liver disease who were prescribed GLP1-RA, a newer medication used to treat diabetes and obesity, had less liver disease progression and were 28% less likely to die of heart attacks than patients prescribed another common diabetes medication, DPP4i. The researchers examined the medical records of nearly 120,000 Veterans with the common liver disease metabolic dysfunction-associated steatotic liver disease (MASLD) between 2005 and 2021. MASLD can lead to liver cirrhosis and is associated with an increased risk of major acute cardiovascular events such as heart attack and stroke. The first line of treatment for MASLD is weight loss, and GLP1-RA is increasingly used to help with weight loss. The findings indicate GLP1-RA can lower the risk of both liver disease progression and heart attack and may be more effective than prioritizing treating liver disease on its own. View the full study from “Diabetes, Obesity and Metabolism.”

Stroke risk higher for women after heart valve replacement

VA Eastern Colorado and University of Colorado researchers learned women were 20% more likely than men to suffer a stroke following a transcatheter aortic valve replacement (TAVR). Also, when women did have a stroke, it was 30% more likely that the stroke will be disabling, leading to death or the inability to return home. The researchers analyzed five years of national data on about 380,000 patients, both Veterans and non-Veterans, who underwent TAVR, a minimally invasive heart procedure for severe aortic stenosis, a narrowing of the heart valve that restricts blood flow. This was the first study that examined the sex differences in stroke severity after a TAVR and adds present-day data to update prior research. The findings emphasize the importance of developing targeted strategies to reduce stroke risk and enhance outcomes for female patients. View the full study from the “Journal of the American Heart Association.”

For more Office of Research and Development updates, visit ORD online or go to https://www.research.va.gov/news_briefs/.