scholarly journals Prognostic value of non-alcoholic fatty liver disease for predicting cardiovascular events in patients with diabetes mellitus with suspected coronary artery disease: a prospective cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Keishi Ichikawa ◽  
Toru Miyoshi ◽  
Kazuhiro Osawa ◽  
Takashi Miki ◽  
Hironobu Toda ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Fatty Liver Disease ◽  
Cardiovascular Events ◽  
Prognostic Value ◽  
Suspected Coronary Artery Disease ◽  
Alcoholic Fatty Liver ◽  
Artery Disease ◽  
Alcoholic Fatty Liver Disease

Abstract Background Risk stratification of cardiovascular events in patients with type 2 diabetes mellitus (T2DM) has not been established. Coronary artery calcium score (CACS) and non-alcoholic fatty liver disease (NAFLD) are independently associated with cardiovascular events in T2DM patients. This study examined the incremental prognostic value of NAFLD assessed by non-enhanced computed tomography (CT) in addition to CACS and Framingham risk score (FRS) for cardiovascular events in T2DM patients. Methods This prospective pilot study included 529 T2DM outpatients with no history of cardiovascular disease who underwent CACS measurement because of suspected coronary artery disease. NAFLD was defined on CT images as a liver:spleen attenuation ratio < 1.0. Cardiovascular events were defined as cardiovascular death, nonfatal myocardial infarction, late coronary revascularization, nonfatal stroke, or hospitalization for heart failure. Results Among 529 patients (61% men, mean age 65 years), NAFLD was identified in 143 (27%). Forty-four cardiovascular events were documented during a median follow-up of 4.4 years. In multivariate Cox regression analysis, NAFLD, CACS, and FRS were associated with cardiovascular events (hazard ratios and 95% confidence intervals 5.43, 2.82–10.44, p < 0.001; 1.56, 1.32–1.86, p < 0.001; 1.23, 1.08–1.39, p = 0.001, respectively). The global χ2 score for predicting cardiovascular events increased significantly from 27.0 to 49.7 by adding NAFLD to CACS and FRS (p < 0.001). The addition of NAFLD to a model including CACS and FRS significantly increased the C-statistic from 0.71 to 0.80 (p = 0.005). The net reclassification achieved by adding CACS and FRS was 0.551 (p < 0.001). Conclusions NAFLD assessed by CT, in addition to CACS and FRS, could be useful for identifying T2DM patients at higher risk of cardiovascular events.

scholarly journals Prognostic Value of Non-alcoholic Fatty Liver Disease in Predicting Cardiovascular Events in Diabetes Mellitus Patients: A Prospective Cohort Study

2020 ◽  
Author(s):  
Keishi Ichikawa ◽  
Toru Miyoshi ◽  
Kazuhiro Osawa ◽  
Takashi Miki ◽  
Hironobu Toda ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Liver Disease ◽  
Coronary Artery ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Cardiovascular Events ◽  
Prognostic Value ◽  
Alcoholic Fatty Liver ◽  
Cox Regression Analysis ◽  
Alcoholic Fatty Liver Disease

Abstract Background: Risk stratification of cardiovascular events in patients with type 2 diabetes mellitus (T2DM) has not been established. coronary artery calcium score (CACS) and non-alcoholic fatty liver disease (NAFLD) are independently associated with cardiovascular events in T2DM patients. This study examined the incremental prognostic value of NAFLD assessed by non-enhanced computed tomography (CT) in addition to CACS and Framingham risk score (FRS) on cardiovascular events in T2DM patients.Methods: This prospective pilot study included 529 T2DM outpatients without history of cardiovascular disease who underwent CACS measurement due to suspected coronary artery disease. NAFLD was defined on CT images as a hepatic: spleen attenuation ratio <1.0. cardiovascular events were defined as cardiovascular death, nonfatal myocardial infarction, late coronary revascularization, nonfatal stroke, or hospitalization for heart failure.Results: Of 529 patients (61% men, mean age 65 years), NAFLD was identified in 143 (27%). During the median 4.4 years of follow-up, 44 cardiovascular events were documented. In multivariate Cox regression analysis, the presence of NAFLD, CACS and FRS were associated with cardiovascular events with hazard ratios of 5.45 (95% confidential interval [CI]: 2.84–10.45; p<0.001), 1.56 (95% CI: 1.32–1.85; p<0.001), and 1.23 (95% CI: 1.08–1.39; p=0.001), respectively. The global chi-square score for predicting cardiovascular events significantly increased from 27.0 to 49.7 by adding NAFLD to CACS and FRS (p<0.001). The addition of NAFLD to a model including CACS and FRS significantly increased the C-statistic from 0.71 to 0.80 (p=0.005). The net reclassification achieved by adding CACS and FRS was 0.551 (p<0.001). Conclusions: NAFLD assessed by CT, in addition to CACS and FRS, could be useful in assessing T2DM patients at higher risk of cardiovascular events.

scholarly journals assosiation of non alcholic fatty liver disease with coronary artery disease

2018 ◽  
Vol 50 (4) ◽  
Author(s):  
Muhammad saad Jibran
Keyword(s):  
Coronary Artery Disease ◽  
Liver Disease ◽  
Coronary Artery ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
P Value ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Artery Disease ◽  
Alcoholic Fatty Liver Disease

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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