January 1, 2007Circulation Journal115 citationsOpen Access

Evaluation of Vulnerable Coronary Plaques and Non-Alcoholic Fatty Liver Disease (NAFLD) by 64-Detector Multislice Computed Tomography (MSCT)

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Suspected coronary artery disease (n=298). Intervention: Non-alcoholic fatty liver disease (NAFLD) vs. Patients without NAFLD. Primary outcome: Presence of coronary remodeling lesions (OR 2.41, 95% CI 1.24-4.67, p=0.009).

SASatoshi Akabame MHMasahide Hamaguchi KTKi-ichiro Tomiyasu

Key Result

Non-alcoholic fatty liver disease was independently associated with a significantly higher risk of vulnerable coronary plaques, including remodeling lesions (adjusted OR 2.41) and lipid core plaques (adjusted OR 2.29).

Study Design

Type

Cross-Sectional (n=298)

Multicenter

PICO

Population

298 patients with suspected coronary artery disease undergoing multislice computed tomography, excluding those with significant alcohol intake or known liver disease.

Exposure / Comparator

Non-alcoholic fatty liver disease (NAFLD) vs Patients without NAFLD

Primary Outcome

Presence of coronary remodeling lesions — OR 2.41 (1.24-4.67), p=0.009

Main Result

Odds Ratio: 2.41 (95% CI 1.24–4.67)

Absolute Event Rate: 31.7% vs 15.5%

p-value: p=0.009

Limitations

Inability to completely exclude all potential confounders
Lack of liver biopsy to definitively confirm NAFLD and its severity
Image quality limitations of MSCT including blurring, spatial resolution, arrhythmia, and motion artifacts
Difficulty in accurately assessing luminal narrowing in calcified lesions

Abstract

BACKGROUND: Multislice computed tomography (MSCT) permits direct visualization of not only coronary artery stenosis but also the characteristics of plaques in patients with coronary artery disease (CAD). Also, because of its potential to be a novel risk factor for cardiovascular disease, interest in non-alcoholic fatty liver disease (NAFLD) is increasing. METHODS AND RESULTS: Participants comprised 298 consecutive patients who received MSCT to diagnose CAD. Patients with an alcohol intake exceeding 20 g/day or with a history of known liver disease were excluded from the study. Liver steatosis and 4 coronary artery findings, including remodeling lesions, lipid core plaques, calcified plaques and narrowing of lumen, were assessed. Liver steatosis was evaluated by computed tomography density of the liver and spleen. In the study, NAFLD was defined as having a liver and spleen (L:S) ratio of <1.1. The L:S ratios of patients with remodeling lesions or lipid core plaques were significantly lower than those without. NAFLD was related significantly to those findings, but there was no correlation between calcified plaques, narrowing of lumen and L:S ratios. Adjusted odds ratio of NAFLD for remodeling lesions was 2.41 (95% confidence interval (CI), 1.24-4.67; p=0.009), and those for lipid core lesions was 2.29 (95% CI, 1.15-4.56; p=0.018). CONCLUSION: NAFLD is a novel risk factor for vulnerable plaques.

Ask AI

Helpful

Bookmark

View Full Paper