What question did this study set out to answer?

To evaluate whether nonalcoholic hepatic steatosis is associated with the presence and characteristics of high-risk coronary-artery plaques detected by multidetector computed tomography.

June 30, 2015PLoS ONEOpen Access

Nonalcoholic Hepatic Steatosis Is a Strong Predictor of High-Risk Coronary-Artery Plaques as Determined by Multidetector CT

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Suspected coronary artery disease (n=414). Intervention: Nonalcoholic hepatic steatosis vs. Absence of nonalcoholic hepatic steatosis. Primary outcome: Presence of high-risk coronary-artery plaques (OR 4.60, 95% CI 1.94-9.07, p=<0.01).

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Key result

Nonalcoholic hepatic steatosis was an independent predictor of high-risk coronary-artery plaques (OR 4.60) in patients with suspected coronary artery disease.

Why the study?

Is nonalcoholic hepatic steatosis associated with an increased presence of high-risk coronary-artery plaques in patients suspected of having coronary artery disease?

Population

414 adults suspected of having coronary artery disease evaluated consecutively with 64-slice MDCT, mean age…

Comparison

Presence of nonalcoholic hepatic steatosis vs Absence of nonalcoholic hepatic steatosis

Design

Cross-sectional

Authors

KOKazuhiro OsawaKawasaki Medical School TMToru MiyoshiOkayama University KYKentarou YamauchiOkayama University

Discussion

Member takes

Implication

No immediate change to CAD risk assessment; leaves open whether steatosis improves high-risk plaque prediction in prospective studies.

Key Points

To evaluate whether nonalcoholic hepatic steatosis is associated with the presence and characteristics of high-risk coronary-artery plaques detected by multidetector computed tomography.
Retrospective study of 414 participants suspected of having coronary artery disease.
Hepatic steatosis was defined as a liver-to-spleen fat ratio of <1.0 on multidetector CT.
Coronary CT angiography evaluated plaques for high-risk features, including low-density plaques, positive remodeling, and spotty calcification.
Patients with hepatic steatosis showed higher rates of low-density plaques (44% vs. 21%, p<0.01), positive remodeling (58% vs. 41%, p=0.01), and spotty calcification (36% vs. 12%, p<0.01) than those without steatosis.
High-risk plaques occurred more frequently in patients with steatosis than in those with isolated elevated visceral adipose tissue ≥86 cm² (35% vs. 16%, p<0.01).
Multivariate analysis showed nonalcoholic hepatic steatosis independently predicted high-risk plaques (odds ratio: 4.60; 95% confidence interval: 1.94–9.07, p<0.01).

Study Design

Type

Cross-Sectional (n=414)

Multicenter

Structured PICO

Is nonalcoholic hepatic steatosis associated with an increased presence of high-risk coronary-artery plaques in patients suspected of having coronary artery disease?

Population

414 adults suspected of having coronary artery disease evaluated consecutively with 64-slice MDCT, mean age 64, 51% male, based in Japan. Excluded patients with implanted coronary-artery stents, prior CABG, unevaluated segments, alcohol consumption >20 g/day, known liver disease (HBV/HCV), or current use of oral corticosteroids/amiodarone.

Intervention

Presence of nonalcoholic hepatic steatosis (defined as a liver-to-spleen fat ratio of <1.0 on non-contrast CT)

Comparator

Absence of nonalcoholic hepatic steatosis (liver-to-spleen fat ratio ≥1.0)

Outcome

Presence of high-risk coronary-artery plaques (defined as having positive remodeling, low-density plaque, and spotty calcification) assessed by coronary CT angiographysurrogate

Main Result

Effect estimate: OR 4.60 (95% CI 1.94-9.07)

Absolute Event Rate: 34% vs 11%

p-value: p=<0.01

Nonalcoholic hepatic steatosis detected by CT is a strong, independent predictor of high-risk coronary plaques, suggesting its value in cardiovascular risk assessment.

Limitations

Cross-sectional design makes determination of causal or temporal relationships difficult.
CT results may not be sufficient for the definitive diagnosis of NAFLD without a liver biopsy.
Patients undergoing statin therapy or with dysthyroidism were not excluded, which might have affected the results.

Cite This Study

Osawa et al. (2015) conducted a cross-sectional in Suspected coronary artery disease (n=414). Nonalcoholic hepatic steatosis vs. Absence of nonalcoholic hepatic steatosis was evaluated on Presence of high-risk coronary-artery plaques (OR 4.60, 95% CI 1.94-9.07, p=<0.01). Nonalcoholic hepatic steatosis was an independent predictor of high-risk coronary-artery plaques (OR 4.60) in patients with suspected coronary artery disease.

synapsesocial.com/papers/6a10ef2b69716c70d0488f08 https://doi.org/10.1371/journal.pone.0131138

Topics

Coronary artery disease

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Nonalcoholic Hepatic Steatosis Is a Strong Predictor of High-Risk Coronary-Artery Plaques as Determined by Multidetector CT

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Nonalcoholic Hepatic Steatosis Is a Strong Predictor of High-Risk Coronary-Artery Plaques as Determined by Multidetector CT

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

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