scholarly journals Coronary artery disease and non‐alcoholic fatty liver disease: Clinical correlation using computed tomography coronary calcium scans

JGH Open ◽  
2021 ◽  
Author(s):  
Richard S Kirby ◽  
Dina Halegoua‐DeMarzio
2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Samira Saraya ◽  
Mahmoud Saraya ◽  
Mohamed Mahmoud ◽  
Mohamed Galal ◽  
Hazem Hamed Soliman ◽  
...  

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is increasing in recognition as a hepatic condition that is unrelated to significant alcoholic consumption, but has rather, been suggested to constitute cardiovascular risk (irrespective of traditional risk factors and high-risk plaque features). Both coronary artery disease and NAFLD share the same pathophysiology and metabolic profile. NAFLD can theoretically be a source/initiator for coronary artery disease (CAD). We aimed to study the association between NAFLD, CAD, the presence of high-risk plaque features, and the severity of stenosis. Results We recruited 800 patients with suspected obstructive CAD and planned for coronary computed tomography angiography (CCTA), Exclusion criteria: heavy alcohol consumption; contraindications to contrast media; unevaluated coronary-artery segments; other known liver disease; and use of oral corticosteroids and/or amiodarone. Non-enhanced Computed Tomography abdomen was performed before the CCTA to detect NAFLD. To study the association between NAFLD and the presence of CAD, patients were classified as to either have, or not have CAD. The CAD group were then further studied for the presence of high-risk plaque features: napkin ring sign, Positive remodelling, Low Hounsfield unit (HU), and Spotty calcium; and their association with NAFLD. Thirty-two per cent of patients had NAFLD and 45% had CAD. A significant association between NAFLD and CAD was found (OR 4.21, 95% CI (confidence interval) (2.83–6.25), p = 0.000). In CAD patients, significant associations were present between NAFLD and high-risk plaque features: Napkin ring sign, Positive remodelling, Low HU, and Spotty calcium (OR 7.88, 95% CI (4.39–14.12), p < 0.001, OR 5.84, 95% (3.85–8.85), p < 0.001, OR 7.25, 95% CI (3.31–15.90), p < 0.001 and OR 6.66, 95% CI (3.75–11.82), p < 0.001), respectively. NAFLD was present in 39.30%, 50.00%, 20.00%, 54.50% and 100.00% of patients with CAD; and 1–24%; 25–49%; 50–69%; 7 = 0–99%, LMD (Left Main Disease) > 50% stenosis or 3V disease, and Total occlusion, respectively, p < 0.001. Conclusions NAFLD is strongly associated with CAD, high-risk plaque features and higher grade of stenosis.


2018 ◽  
Vol 50 (4) ◽  
Author(s):  
Muhammad saad Jibran

OBJECTIVE: To determine the association between non alcoholic fatty liver disease and coronary artery disease. METHODOLOGY: This cross sectional study is conducted from July 2016 to December 2016, in cardiology unit, Lady reading hospital. By using non probability consecutive sampling, patients of all age groups and either gender, presenting to cath: lab for coronary angiography, indicated for angina CCS III, were included in the study. All patients fulfilling inclusion and exclusion criteria were subjected to screening for NAFLD by using ultrasonography. Patients were classified into having no, mild, moderate and sever NAFLD. Correlation between NAFLD and CAD, confirmed on cath: studies, was done using Spearman’s rho test. RESULTS: Total of 370 patients with mean age of 55.36 ± 10.07 years were enrolled in the study, of which 44.6% were females. Known risk factors for CAD like Diabetes mellitus, hypertension, and smoking were present in 63.5%, 64.9% and 23% respectively. 28.4% of patients had no NAFLD, 28.4% had mild, 28.4% had moderate and 14.4% had sever NAFLD. 12.2% had no CAD while mild, moderate and sever disease was present in 36.5%, 31.1% and 2.3% respectively. By using chi square test co relation co efficient between NAFLD and CAD was calculated and came out to be 285.536 ( p value <0.000). NAFLD also increased the odds of having CAD by 2.9 times with a p value for odd ratio <0.000. CONCLUSION: NAFLD is strongly associated as an independent risk factor with CAD and increases the odds of having CAD. KEY WORDS:  NAFLD= Non alcoholic fatty liver disease, CAD= Coronary artery disease, CCS= Canadian classification scale, Cath:= Cardiac catheterization


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