Coronary artery disease and cardiovascular outcomes in patients with non-alcoholic fatty liver disease.

Abstract

OBJECTIVE:

Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and is associated with cardiovascular risk. The aim of this study was to determine the role of fatty liver in predicting coronary artery disease and clinical outcomes in patients undergoing coronary angiogram.

METHODS:

This was a prospective cohort study carried out in a University hospital. Consecutive patients who underwent coronary angiogram had ultrasound screening for fatty liver. Significant cardiovascular disease was defined as ≥50% stenosis in at least one coronary artery. The primary outcome was a composite end point comprising cardiovascular deaths, non-fatal myocardial infarction and the need for further coronary intervention during prospective follow-up.

RESULTS:

Among 612 recruited patients, 356 (58.2%) had fatty liver by ultrasonography, 318 (52.0%) had elevated serum alanine aminotransferase and 465 (76.0%) had significant coronary artery disease. Coronary artery disease occurred in 84.6% of patients with fatty liver and 64.1% of those without fatty liver (p<0.001). After adjusting for demographic and metabolic factors, fatty liver (adjusted OR 2.31; 95% CI 1.46 to 3.64) and alanine aminotransferase level (adjusted OR 1.01; 95% CI 1.00 to 1.02) remained independently associated with coronary artery disease. At a mean follow-up of 87±22 weeks, 30 (10.0%) patients with fatty liver and 18 (11.0%) patients without fatty liver reached the composite clinical end point (p=0.79).

CONCLUSIONS:

In patients with clinical indications for coronary angiogram, fatty liver is associated with coronary artery disease independently of other metabolic factors. However, fatty liver cannot predict cardiovascular mortality and morbidity in patients with established coronary artery disease.

• Authors: Vincent Wai-Sun Wong, Grace Lai-Hung Wong, Gabriel Wai-Kwok Yip, Angeline Oi-Shan Lo, Jenny Limquiaco, Winnie Chiu-Wing Chu, Angel Mei-Ling Chim, Cheuk-Man Yu, Jun Yu, Francis Ka-Leung Chan, Joseph Jao-Yiu Sung, Henry Lik-Yuen Chan
• Journal: Gut (Gut) Vol. 60 Issue 12 Pg. 1721-7 (Dec 2011) ISSN: 1468-3288 [Electronic] England
• PMID: 21602530 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Alcohol Drinking (epidemiology)
• Angioplasty, Balloon, Coronary
• Chi-Square Distribution
• Coronary Angiography (statistics & numerical data)
• Coronary Artery Bypass
• Coronary Artery Disease (complications, diagnostic imaging, epidemiology, surgery)
• Fatty Liver (complications, epidemiology)
• Female
• Humans
• Logistic Models
• Male
• Middle Aged
• Non-alcoholic Fatty Liver Disease
• Proportional Hazards Models
• Prospective Studies
• Treatment Outcome