Methacetin Breath Test in Patients With Liver Disease Secondary to Heart Disease

Non-alcoholic fatty liver disease is considered as an independent predictor of cardiovascular diseases which plays an important role in the development of ischemic heart disease. The drug most frequently used for treating this comorbidity is atorvastatin which favours better survival outcomes and is essential in the primary and secondary prevention of cardiovascular diseases. Ursodeoxycholic acid is prescribed as an alternative therapy for ischemic heart disease with co-existent non-alcoholic fatty liver disease and obesity to eliminate statin side effects. The use of ursodeoxycholic acid as a hepatoprotector in comprehensive basic treatment contributes to the improvement of the cardiovascular system in patients with ischemic heart disease as well as the increase in treatment efficacy; it improves the functional status of the liver affecting the major pathogenic mechanisms of the disease.The objective of the research was to study the effect of combined hypolipidemic therapy with atorvastatin and ursodeoxycholic acid on the indices of blood lipids, liver transaminase levels, functional status of the liver and the course of non-alcoholic fatty liver disease in patients with ischemic heart disease and obesity.Materials and methods. 20 patients with ischemic heart disease, co-existent non-alcoholic fatty liver disease and obesity were examined. They received ursodeoxycholic acid in addition to atorvastatin for four weeks. All the patients underwent clinical tests, visceral ultrasonography, blood lipid test, liver transaminase test and 13C-methacetin breath test.Results. The study revealed a significant decrease in the level of the pro-atherogenic fractions of blood lipids (р<0.01) as well as an improved functional status of the liver due to a significant increase in metabolic capacity of the liver and cumulative dose on the 40th and 120th minutes after ursodeoxycholic acid administration (р<0.01).Conclusions. The use of ursodeoxycholic acid in addition to atorvastatin in patients with ischemic heart disease, co-existent non-alcoholic fatty liver disease and obesity makes it possible to avoid the adverse effect of hypolipidemic therapy on the functional status of the liver.

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Model for End-Stage Liver Disease Score Predicts the Mortality of Patients with Coronary Heart Disease Who Underwent Percutaneous Coronary Intervention

Cardiology Research and Practice ◽

10.1155/2021/6401092 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

You Chen ◽

Min Han ◽

Ying-Ying Zheng ◽

Feng Zhu ◽

Aikebai Aisan ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Liver Disease ◽

Coronary Intervention ◽

Meld Score ◽

Bleeding Events ◽

Percutaneous Coronary ◽

End Stage ◽

Long Term Mortality

Background. Coronary heart disease (CHD) is caused by the blockage or spasm of coronary arteries. Evidence shows that liver disease is related to CHD. However, the correlation between the Model for End-Stage Liver Disease (MELD) score and outcomes in patients after percutaneous coronary intervention (PCI) was unclear. Method. A retrospective cohort study involved 5373 patients with coronary heart disease after PCI was conducted from January 2008 to December 2016. Participants were classified to four groups according to the MELD score by quartiles. The primary endpoint was long-term mortality including all-case mortality (ACM) and cardiac mortality (CM). Secondary endpoints included bleeding events, readmission, major adverse cardiovascular events (MACE), major adverse cardiovascular, and cerebrovascular events (MACCE). The longest follow-up time was almost 10 years. Results. There were significant differences in the incidences of ACM ( p = 0.038 ) and CM ( p = 0.027 ) among the four MELD groups, but there was no significant difference in MACEs ( p = 0.496 ), MACCEs ( p = 0.234 ), readmission ( p = 0.684 ), and bleeding events ( p = 0.232 ). After adjusting the age, gender, smoking, drinking status, and diabetes by a multivariable Cox regression analysis, MELD remains independently associated with ACM (HR:1.57, 95%CI 1.052–2.354, p = 0.027 ) and CM (HR:1.434, 95% CI 1.003–2.050, p = 0.048 ). Conclusion. This study indicated that the MELD score had a strong prediction for long-term mortality in CHD patients who underwent PCI.

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