Association between Nonalcoholic Fatty Liver and Gensini Score in Patients with Coronary Heart Disease: A Cross-Sectional Study

Increased prevalence of high-risk coronary plaques in metabolic dysfunction associated stetatotic liver disease patients: A meta-analysis

BACKGROUND

Metabolic dysfunction associated steatotic liver disease (MASLD) is associated with an increased risk of coronary artery disease. Computed Tomography Coronary Angiography (CTCA) can assess both the extent and the features of coronary plaques. We aimed to gather evidence about the prevalence and features of coronary plaques among MASLD patients.

METHODS

PubMed, Scopus, and Google Scholar databases were searched for randomized controlled trials and adjusted observational studies assessing the prevalence and features of coronary plaques by means of CTCA in MASLD patients as compared with a control group. The prevalence of coronary stenosis (defined as >30% and >50% diameter of stenosis), of increasing coronary artery calcium (CAC) score and of high-risk features (namely low-attenuation plaques, napkin ring sign, spotty calcification and positive remodelling) in MASLD patients were the endpoints of interest.

RESULTS

Twenty-four observational studies were included. MASLD was associated with an increased prevalence of critical coronary stenosis compared with controls (odds ratio [OR] 1.54, 95%CI 1.23-1.93). Increased values of CAC score were observed in MASLD patients (OR 1.35, 95%CI 1.02-1.78 and OR 2.26, 95%CI 1.57-3.23 for CAC score 0-100 and >100, respectively). An increased risk of 'high-risk' coronary plaques was observed in MASLD patients (OR 2.13, 95%CI 1.42-3.19). As high-risk features plaques, a higher prevalence of positive remodelling and spotty calcification characterize MASLD patients (OR 2.92, 95%CI 1.79-4.77 and OR 2.96, 95%CI 1.22-7.20).

CONCLUSIONS

Patients with MASLD are at increased risk of developing critical coronary stenosis and coronary plaques characterized by high-risk features as detected by CTCA.

Correlation Analysis of CML, sRAGE, and esRAGE and the Measure of Atherosclerosis of Coronary Heart Disease

Objective

To investigate the correlation between CML, sRAGE, and esRAGE and the measure of atherosclerosis of coronary heart disease.

Methods

From June 2019 to December 2021, there were 100 patients in all suffering from coronary heart disease (CHD) selected as the observation group. On the basis of Gensini score, they were divided into mild group (Gensini score < 12 points), moderate group (12 points ≤ Gensini score ≤60 points), and severe group (Gensini score > 60). Apart from that, 50 normal people staying in our hospital for physical examination were chosen as the control group in the meantime. N in each group was detected and compared ε-Carboxymethyl lysine (CML), soluble advanced glycation end product receptor (sRAGE), and endogenous secretory advanced glycation end product receptor (esRAGE). Pearson correlation coefficient was adapted to assay the relevance between CML, sRAGE, and esRAGE, as well as the degree of atherosclerosis in CHD. Receiver operator characteristic (ROC) curve was applied to during the evaluation of the diagnosis of CML, sRAGE, and esRAGE, as well as their combined detection of severe atherosclerosis in CHD.

Results

In contrast with the control group, the level of serum CML together with sRAGE in the observation group was considerably elevated, while the level of esRAGE appeared in a downward trend (P < 0.05). The level of serum CML and sRAGE was directly proportional to the measure of atherosclerosis in CHD, while the level of esRAGE was inversely proportional to the measure of atherosclerosis in CHD (P < 0.05). That is to say that serum CML and sRAGE were positive in matter of the measure of atherosclerosis in CHD, while esRAGE negatively appertains to the measure of atherosclerosis in CHD (P < 0.05). Serum CML, sRAGE, and esRAGE could effectively diagnose severe atherosclerosis in CHD, and the combined detection sensitivity (89.79%), specificity (77.16%), accuracy (86.12%), positive predictive value (86.63%), negative predictive value (88.59%), and area under ROC curve (AUC) (0.924) were higher (P < 0.05).

Conclusion

CML and sRAGE, as well as esRAGE, are bound up with the degree of atherosclerosis in CHD, which is conducive to clinical diagnosis and treatment.

Correlation analysis of epicardial adipose tissue volume quantified by computed tomography images and coronary heart disease under optimized reconstruction algorithm

Objectives:

This paper was aimed to explore the adoption value of low-dose computed tomography (CT) imaging based on optimized ordered subset expectation maximization (OSEM) reconstruction algorithm in the correlation analysis between epicardial adipose tissue (EAT) volume and coronary heart disease (CHD).

Methods:

A total of 110 patients with CHD were selected for CT angiography (CTA) and coronary arteriography (CAG) examinations from October 2017 to October 2019. The predictive value of EAT for CHD was analyzed via receiver operating characteristic (ROC) curve.

Results:

The results showed that the iteration time and error of the improved OSEM reconstruction algorithm were better than that of MLEM algorithm under the same number of iterations. Age, smoking, hypertension, diabetes, and EAT in control group were obviously lower in contrast to those in CHD group (P<0.05). EAT in control group was (124.50±26.72) mL, and EAT in the CHD group was (159.41±38.51) mL. EAT (B=0.023, P=0.003) was an independent risk factor for CHD, which was suggested by Multiple linear regression analysis. Moreover, EAT was a risk factor for CHD, and was positively correlated with the degree and NSCV.

Conclusion:

The optimized OSEM algorithm was used to improve the reconstruction quality of low-dose CT images and used in quantitative measurement of epicardial fat volume. Results showed EAT was an independent risk factor for CHD, and was positively correlated with the number of coronary lesions and Gensini score. It was of great value for the prediction of CHD.

Risk of Cardiovascular Disease in Individuals With Nonobese Nonalcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease (NAFLD) is independently associated with obesity and cardiovascular disease (CVD). CVD is the primary cause of mortality in the predominantly obese population of adults with NAFLD. NAFLD is increasingly seen in individuals who are lean and overweight (i.e., nonobese), but it is unclear whether their risk of CVD is comparable to those with NAFLD and obesity. Using a prospective cohort of patients with NAFLD, we compared the prevalence and incidence of CVD in individuals with and without obesity. NAFLD was diagnosed by biopsy or imaging after excluding other chronic liver disease etiologies. Logistic regression was used to compare the odds of baseline CVD by obesity status. Cox proportional hazards regression was used to evaluate obesity as a predictor of incident CVD and to identify predictors of CVD in subjects with and without obesity. At baseline, adults with obesity had a higher prevalence of CVD compared to those without obesity (12.0% vs. 5.0%, P = 0.02). During follow-up, however, obesity did not predict incident CVD (hazard ratio [HR], 1.24; 95% confidence interval [CI], 0.69-2.22) or other metabolic diseases. Findings were consistent when considering body mass index as a continuous variable and after excluding subjects who were overweight. Age (adjusted HR [aHR], 1.05; 95% CI, 1.03-1.08), smoking (aHR, 4.61; 95% CI, 1.89-11.22), and decreased low-density lipoprotein levels (aHR, 0.98; 95% CI, 0.96-1.00) independently predicted incident CVD in the entire cohort, in subjects with obesity, and in those without obesity, respectively. Conclusion: Individuals with overweight or lean NAFLD are not protected from incident CVD compared to those with NAFLD and obesity, although CVD predictors appear to vary between these groups. Patients without obesity also should undergo rigorous risk stratification and treatment.