Xuan JM, Li G, Ma JY. Relationship between nonalcoholic fatty liver disease and coronary plaque stability and risk factors for composite cardiovascular adverse events.
Shijie Huaren Xiaohua Zazhi 2022;
30:810-816. [DOI:
10.11569/wcjd.v30.i18.810]
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Abstract
BACKGROUND
Cardiovascular disease is a major disease threatening human life and health. In recent years, the relationship between cardiovascular disease and non-alcoholic fatty liver disease has become a research hotspot. Non-alcoholic fatty liver disease is closely related to the severity of coronary heart disease, which can be used for preliminary assessment of the risk of cardiovascular events in coronary heart disease.
AIM
To explore the relationship between non-alcoholic fatty liver disease (NAFLD) and coronary plaque stability and the multivariate analysis of prognosis.
METHODS
A total of 320 patients who underwent coronary CT angiography at our hospital from January 2019 to January 2021 were selected and divided into an NAFLD group (n = 91) and a non-NAFLD group (n = 229) according to the presence or absence of NAFLD. The general data and coronary plaque presence (plaque presence rate and plaque number) were compared between the two groups, and coronary plaque stability (soft plaque, mixed plaque, and hard plaque) in NAFLD patients with different degrees of fatty liver degeneration were compared. Spearman correlation was used to analyze the correlation between the degree of fatty liver degeneration and coronary plaque stability and Gensini score. All patients were followed for 12 mo, and composite cardiovascular adverse events (coronary revascularization, myocardial infarction, all-cause death, and cardiac death) were counted. The clinical data of patients with different prognoses were compared, and the prognostic factors were analyzed by multivariate Logistic regression.
RESULTS
The proportion of patients with coronary plaques (76.92%) and the proportion of patients with ≥ 2 coronary plaques (12.09%) in the NAFLD group were significantly higher than those in the non-NAFLD group (58.08% and 4.37%, respectively, P < 0.05). Patients with severe fatty liver degeneration had the highest proportion of soft plaques and Gensini score followed by those with moderate and mild fatty liver degeneration (P < 0.05); the degree of fatty liver degeneration in the NAFLD group was positively correlated with coronary plaque stability and Gensini score (P < 0.05). Body mass index, proportion of patients with diabetes, TG level, proportion of patients with NAFLD, and proportion of soft plaques in patients with composite adverse cardiovascular events were higher than those in patients without (P < 0.05). BMI, diabetes, TG level, NAFLD, and soft plaque were independent risk factors for compound cardiovascular adverse events (P < 0.05).
CONCLUSION
NAFLD is closely related to the stability of coronary plaque and the degree of coronary stenosis in CVD patients, and both NAFLD and coronary plaque instability are prognostic risk factors for composite cardiovascular adverse events.
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