Association Between Nonalcoholic Fatty Liver Disease and Coronary Artery Disease Complexity in Patients With Acute Coronary Syndrome

Ağaç, Mustafa Tarık; Korkmaz, Levent; Çavuşoğlu, Gökhan; Karadeniz, Ayşe Gül; Ağaç, Süret; Bektaş, H.; Erkan, Hakan; Varol, Mustafa Oğuz; Vatan, Mehmet Bülent; Acar, Zeydin; Menteşe, Ümit; Çelık, Şükrü

doi:10.1177/0003319713479155

Cited by 37 publications

(44 citation statements)

References 14 publications

(29 reference statements)

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“…Patients without cirrhosis with nonalcoholic fatty liver disease have been shown to have higher disease severity, (35) vulnerable plaque formation, (36) greater burden of lipid core plaques, (29) poor coronary collateral development, (37) and more complex CAD. (38) In patients with NASH cirrhosis, CAD was noted in over half of the study population with nearly a third having obstructive CAD. NASH cirrhosis was also a strong predictor of CAD independent of traditional risk factors including age, sex, BMI, smoking, and family history.…”

Section: Discussionmentioning

confidence: 92%

“…These findings reflect previously published data linking CAD with both NASH and HCV in patients without cirrhosis. Patients without cirrhosis with nonalcoholic fatty liver disease have been shown to have higher disease severity, vulnerable plaque formation, greater burden of lipid core plaques, poor coronary collateral development, and more complex CAD . In patients with NASH cirrhosis, CAD was noted in over half of the study population with nearly a third having obstructive CAD.…”

Section: Discussionmentioning

confidence: 98%

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Coronary artery disease in decompensated patients undergoing liver transplantation evaluation

Patel¹,

Nabi²,

Guzmán³

et al. 2018

Liver Transpl

102

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Coronary artery disease (CAD) is an important contributor to morbidity and mortality in patients undergoing liver transplantation (LT). However, the current literature is limited by sampling bias and nondefinitive assessment of CAD. The current study examines the prevalence of CAD via per protocol coronary angiography and its relationship to etiology of liver disease in patients undergoing liver transplantation evaluation (LTE). Data on 228 patients were prospectively collected who had coronary angiography as part of LTE between 2011 and 2014. Coronary angiography was done in all patients age ≥50 years or with CAD risk factors. CAD was defined as any coronary artery stenosis, whereas stenosis ≥ 70% in distribution of 1 or 3 major coronary arteries was considered as single- or triple-vessel disease. CAD was detected in 36.8% of patients, with the highest prevalence among nonalcoholic steatohepatitis (NASH) patients with cirrhosis (52.8%). Prevalence of single-vessel disease was higher among patients with NASH compared with hepatitis C virus (HCV) and alcoholic cirrhosis (15.1% versus 4.6% versus 6.6%; P = 0.02). Similarly, patients with NASH were more likely to have triple-vessel disease when compared with HCV and alcoholic cirrhosis (9.4% versus 0.9% versus 0%; P = 0.001). While adjusting for traditional risk factors for CAD, only NASH as etiology of liver disease remained significantly associated with CAD. Complications from diagnostic coronary angiography or percutaneous coronary intervention were low (2.6%). In conclusion, patients undergoing LTE have a high prevalence of CAD, which varies widely depending on etiology of liver cirrhosis. The procedural complications from coronary angiography are low. Liver Transplantation 24 333-342 2018 AASLD.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Coronary artery disease in decompensated patients undergoing liver transplantation evaluation

Patel¹,

Nabi²,

Guzmán³

et al. 2018

Liver Transpl

102

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“…Nonalcoholic fatty liver disease (NAFLD) was highly prevalent in patients with acute coronary syndrome [1]. It also has been associated with high cardiovascular risk and mortality in patients with coronary heart disease (CHD) [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…Several studies demonstrated correlation between NAFLD and SS [1]. However, SS II does not consider liver state.…”

Section: Introductionmentioning

confidence: 99%

Prognostication of Cardiovascular Risk in Patients with Stable Coronary Heart Disease Depending on SYNTAX Score II on the Background of Nonalcoholic Fatty Liver Disease

Vakalyuk¹

2017

ujph

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Aim of the study was to evaluate the contribution of nonalcoholic fatty liver disease in predicting risk of major cardiovascular events by cumulative proportion surviving depending on the SYNTAX score II in patients with stable coronary heart disease. Materials and methods: Patients with stable coronary heart disease with and without nonalcoholic fatty liver disease underwent clinical examinations, electrocardiography, echocardiography, liver elastography, liver ultrasound, evaluation of the liver functional state. Then SYNTAX score I and II were calculated to all patients. Results: The two-year death-free survival (100.00% vs. 60.00%; P = 0.0165), and a repeated nonfatal myocardial infarction-free survival (85.36% vs. 33.33%; P = 0.0045), and a stroke-free survival (88.95% vs. 37.85%; P = 0.0021), and a repeated revascularization-free survival (85.83% vs. 31.81%; P = 0.0006) in patients with SS II ≥29 and without nonalcoholic fatty liver disease were significant higher than in those with nonalcoholic steatohepatitis. Conclusions: the long-term prognosis of the patients with stable coronary heart disease is a most prognostically unfavorable on the background of SYNTAX score II ≥29 and nonalcoholic steatohepatitis combination.

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“…We read the article ''Association between nonalcoholic fatty liver disease and coronary artery disease complexity in patients with acute coronary syndrome: a pilot study'' by Agaç et al 1 The authors assessed the relationship between nonalcoholic fatty liver disease (NAFLD) and SYNTAX score (SS) in patients who presented with acute coronary syndrome (ACS). They concluded that the presence of NAFLD is associated with higher SS in these patients.…”

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confidence: 99%

Nonalcoholic Fatty Liver Disease May Be Associated With Coronary Artery Disease Complexity

Balta

Demırkol

et al. 2013

Angiology

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We read the article ''Association between nonalcoholic fatty liver disease and coronary artery disease complexity in patients with acute coronary syndrome: a pilot study'' by Agaç et al. 1 The authors assessed the relationship between nonalcoholic fatty liver disease (NAFLD) and SYNTAX score (SS) in patients who presented with acute coronary syndrome (ACS). They concluded that the presence of NAFLD is associated with higher SS in these patients.Serum alanine transaminase and aspartate transaminase activities are independently positively associated with the risk and severity of premature coronary artery disease (CAD), suggesting that these enzymes could serve as surrogate markers for cardiovascular (CV) risk in this specific group of patients. 2 Serum g-glutamyltransferase activity is also an indicator of oxidative stress and is associated with CV disease. 3 These associations can be partly attributed to NAFLD and insulin resistance, but there may be additional underlying mechanisms that contribute to the increased CV risk (eg, inflammation and oxidative stress). 4 The NAFLD is a hepatic manifestation of metabolic syndrome (MetS). 5 The MetS is a clinical entity comprising risk factors such as hypertension, 6 glucose intolerance, atherogenic lipid profile, abdominal obesity, lack of physical activity, and increased inflammatory state. 5 Most of the recent studies demonstrated that there was a correlation between the inflammatory mediators and the components of MetS. Elevated inflammatory mediators are a common indicator of atherosclerotic involvement of the vascular structure indicating CAD, cerebrovascular disease, peripheral arterial disease, and chronic inflammatory disease. 7 Inflammatory mediators can also be affected by atherosclerotic risk factors such as smoking, alcohol consumption, hypercholesterolemia, and hypothyroidism. In this context, the authors 1 did not mention some of the factors affecting these markers, including alcohol consumption, insulin resistance, hypercholesterolemia, hypothyroidism, heart failure, cerebrovascular disease, peripheral arterial disease, and chronic inflammatory disease in their study. Obstructive sleep apnoea syndrome (OSAS) and NAFLD are common conditions in clinical practice. Patients with OSAS should be screened for the presence and severity of NAFLD. 8 It would be useful if the authors 1 provided information about these factors.

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Association Between Nonalcoholic Fatty Liver Disease and Coronary Artery Disease Complexity in Patients With Acute Coronary Syndrome

Cited by 37 publications

References 14 publications

Coronary artery disease in decompensated patients undergoing liver transplantation evaluation

Coronary artery disease in decompensated patients undergoing liver transplantation evaluation

Prognostication of Cardiovascular Risk in Patients with Stable Coronary Heart Disease Depending on SYNTAX Score II on the Background of Nonalcoholic Fatty Liver Disease

Nonalcoholic Fatty Liver Disease May Be Associated With Coronary Artery Disease Complexity

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