Prognostic Value of Coronary Computed Tomographic Angiography in Patients With Nonalcoholic Fatty Liver Disease

Ichikawa, Keishi; Miyoshi, Toru; Osawa, Kazuhiro; Miki, Takashi; Nakamura, Kazufumi; Ito, Hiroshi

doi:10.1016/j.jcmg.2020.01.022

Cited by 17 publications

(23 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An abdominal non-contrast CT scan was performed just before the cardiac scan on the same day, as previously described. [ 2 , 11 ] Hepatic and splenic Hounsfield attenuations were measured in the largest possible regions. The regions of interest included 2 areas that were aligned to the anterior-posterior dimension of the right liver lobe and one that was aligned to the spleen.…”

Section: Methodsmentioning

confidence: 99%

“…High-risk plaques were defined when 2 or more plaque characteristics, including positive remodeling, low-density plaques, and spotty calcification were present, as previously described. [ 2 ]…”

Section: Methodsmentioning

confidence: 99%

“…[ 1 ] NAFLD is not only associated with increased liver-related mortality, but also with increased cardiac mobility and mortality. [ 2 , 3 ] Earlier, we reported a significant association between NAFLD and the presence of high-risk plaques on coronary computed tomography angiography (CTA) that increase the likelihood of cardiovascular events. [ 4 ] Emerging evidence demonstrated that NAFLD represented a chronic low-grade inflammatory state, characterized by elevated circulating levels of cytokines and activation of pro-inflammatory signaling pathways.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Association between higher pericoronary adipose tissue attenuation measured by coronary computed tomography angiography and nonalcoholic fatty liver disease

et al. 2021

Self Cite

View full text Add to dashboard Cite

Non-alcoholic fatty liver disease (NAFLD) is a risk factor for cardiac mortality. Pericoronary adipose tissue (PCAT) attenuation, expressed by the fat attenuation index on coronary computed tomography angiography, reflects pericoronary inflammation. We aimed to investigate the association between PCAT attenuation and NAFLD. This is a single-center cohort study comprising of patients who underwent coronary computed tomography angiography for suspected stable coronary artery disease between January and December 2020. Patient characteristics and coronary computed tomography angiography findings were analyzed between patients with NAFLD (n = 78) and a propensity score-matched cohort of patients without NAFLD (n = 78). PCAT attenuation was assessed in Hounsfield units (HU) of proximal 40-mm segments of the left anterior descending artery (LAD) and right coronary artery. The mean PCAT attenuation in LAD and right coronary artery were significantly higher in patients with NAFLD than those without NAFLD. When patients were divided into 2 groups using the median LAD-PCAT attenuation of −72.5 HU, the high PCAT attenuation group had more males (82% vs 67%, P = .028) and NAFLD patients (63% vs 37%, P = .001) compared to the low PCAT attenuation group. No differences in age, body mass index, conventional cardiovascular risk factors, or the presence of high-risk plaque were observed between the 2 groups. In the multivariate logistic analysis, NAFLD was independently associated with high PCAT attenuation (odds ratio 2.912, 95% confidence interval 1.386 to 6.118, P = .005). NAFLD is associated with high PCAT attenuation on coronary computed tomography angiography. This finding suggests that pericoronary inflammation is involved in the increased cardiac mortality in NAFLD patients.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association between higher pericoronary adipose tissue attenuation measured by coronary computed tomography angiography and nonalcoholic fatty liver disease

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Previous studies showed that metabolic syndrome and T2DM might be predictors of vascular damage [11,12], and complex and bidirectional associations have been demonstrated between NAFLD and metabolic syndrome and T2DM [13]. We recently reported on the prognostic value of NAFLD assessed by non-enhanced CT in patients with suspected coronary artery disease who underwent coronary CT angiography [14], highlighting the benefits of concomitant assessment of liver fat content during the acquisition of coronary CT angiography to detect patients at higher risk of cardiovascular events.…”

Section: Introductionmentioning

confidence: 97%

Prognostic value of non-alcoholic fatty liver disease for predicting cardiovascular events in patients with diabetes mellitus with suspected coronary artery disease: a prospective cohort study

Ichikawa

Miyoshi

Osawa

et al. 2021

Cardiovasc Diabetol

Self Cite

View full text Add to dashboard Cite

Background Risk stratification of cardiovascular events in patients with type 2 diabetes mellitus (T2DM) has not been established. Coronary artery calcium score (CACS) and non-alcoholic fatty liver disease (NAFLD) are independently associated with cardiovascular events in T2DM patients. This study examined the incremental prognostic value of NAFLD assessed by non-enhanced computed tomography (CT) in addition to CACS and Framingham risk score (FRS) for cardiovascular events in T2DM patients. Methods This prospective pilot study included 529 T2DM outpatients with no history of cardiovascular disease who underwent CACS measurement because of suspected coronary artery disease. NAFLD was defined on CT images as a liver:spleen attenuation ratio < 1.0. Cardiovascular events were defined as cardiovascular death, nonfatal myocardial infarction, late coronary revascularization, nonfatal stroke, or hospitalization for heart failure. Results Among 529 patients (61% men, mean age 65 years), NAFLD was identified in 143 (27%). Forty-four cardiovascular events were documented during a median follow-up of 4.4 years. In multivariate Cox regression analysis, NAFLD, CACS, and FRS were associated with cardiovascular events (hazard ratios and 95% confidence intervals 5.43, 2.82–10.44, p < 0.001; 1.56, 1.32–1.86, p < 0.001; 1.23, 1.08–1.39, p = 0.001, respectively). The global χ2 score for predicting cardiovascular events increased significantly from 27.0 to 49.7 by adding NAFLD to CACS and FRS (p < 0.001). The addition of NAFLD to a model including CACS and FRS significantly increased the C-statistic from 0.71 to 0.80 (p = 0.005). The net reclassification achieved by adding CACS and FRS was 0.551 (p < 0.001). Conclusions NAFLD assessed by CT, in addition to CACS and FRS, could be useful for identifying T2DM patients at higher risk of cardiovascular events.

show abstract

“…There is a complex and bidirectional relationship between NAFLD and T2DM [11]. Recently, we reported the prognostic value of NAFLD assessed by non-enhanced CT in patients with suspected coronary artery disease who underwent coronary CT angiography [12], highlighting the bene ts of concomitant assessment of liver fat content during the acquisition of coronary CT angiography to detect patients at higher risk of cardiovascular events.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Non-alcoholic Fatty Liver Disease in Predicting Cardiovascular Events in Diabetes Mellitus Patients: A Prospective Cohort Study

Ichikawa¹,

Miyoshi²,

Osawa³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Risk stratification of cardiovascular events in patients with type 2 diabetes mellitus (T2DM) has not been established. coronary artery calcium score (CACS) and non-alcoholic fatty liver disease (NAFLD) are independently associated with cardiovascular events in T2DM patients. This study examined the incremental prognostic value of NAFLD assessed by non-enhanced computed tomography (CT) in addition to CACS and Framingham risk score (FRS) on cardiovascular events in T2DM patients.Methods: This prospective pilot study included 529 T2DM outpatients without history of cardiovascular disease who underwent CACS measurement due to suspected coronary artery disease. NAFLD was defined on CT images as a hepatic: spleen attenuation ratio <1.0. cardiovascular events were defined as cardiovascular death, nonfatal myocardial infarction, late coronary revascularization, nonfatal stroke, or hospitalization for heart failure.Results: Of 529 patients (61% men, mean age 65 years), NAFLD was identified in 143 (27%). During the median 4.4 years of follow-up, 44 cardiovascular events were documented. In multivariate Cox regression analysis, the presence of NAFLD, CACS and FRS were associated with cardiovascular events with hazard ratios of 5.45 (95% confidential interval [CI]: 2.84–10.45; p<0.001), 1.56 (95% CI: 1.32–1.85; p<0.001), and 1.23 (95% CI: 1.08–1.39; p=0.001), respectively. The global chi-square score for predicting cardiovascular events significantly increased from 27.0 to 49.7 by adding NAFLD to CACS and FRS (p<0.001). The addition of NAFLD to a model including CACS and FRS significantly increased the C-statistic from 0.71 to 0.80 (p=0.005). The net reclassification achieved by adding CACS and FRS was 0.551 (p<0.001). Conclusions: NAFLD assessed by CT, in addition to CACS and FRS, could be useful in assessing T2DM patients at higher risk of cardiovascular events.

show abstract

Prognostic Value of Coronary Computed Tomographic Angiography in Patients With Nonalcoholic Fatty Liver Disease

Cited by 17 publications

References 3 publications

Association between higher pericoronary adipose tissue attenuation measured by coronary computed tomography angiography and nonalcoholic fatty liver disease

Association between higher pericoronary adipose tissue attenuation measured by coronary computed tomography angiography and nonalcoholic fatty liver disease

Prognostic value of non-alcoholic fatty liver disease for predicting cardiovascular events in patients with diabetes mellitus with suspected coronary artery disease: a prospective cohort study

Prognostic Value of Non-alcoholic Fatty Liver Disease in Predicting Cardiovascular Events in Diabetes Mellitus Patients: A Prospective Cohort Study

Contact Info

Product

Resources

About