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NAFLD associated with high-risk coronary plaque

In a new study, nonalcoholic fatty liver disease, or NAFLD, was found to be associated with high-risk coronary plaque, after researchers used coronary computed tomographic angiography to assess any relationship between the two.

“As it is known that atherosclerosis is linked to inflammation, our next step was to look for an association of high-risk plaques with other systemic inflammatory conditions such as NAFLD,” researchers Stefan B. Puchner, MD, of Massachusetts General Hospital and Harvard Medical School, said in a press release. “Interestingly, both pathologies can be detected in a single CT [computed tomographic] examination.”

Puchner and colleagues analyzed data from 445 patients included in the ROMICAT II trial who underwent unenhanced CT and material enhanced coronary CT angiography. All patients were previously examined for chest pain in the emergency department of nine hospitals throughout the US.

NAFLD was prevalent in 182 patients, according to CT. Compared with patients without NAFLD, the patients with NAFLD were older (56.2±8.0 vs. 52.2±7.7; P<.001), more likely male (55.5% vs. 34% women; P<.001), had a greater body mass index (30.3±4.8 vs. 28.8±5.2; P=.002) and had a greater prevalence of cardiovascular risk factors. Coronary plaque was found in 248 patients (55.7%) at CT and 42 of these patients had coronary artery disease (CAD). The patients with NAFLD showed “significant and nonobstructive CAD,” as well as greater prevalence of high-risk plaque features, compared with the patients without NAFLD.

After adjustment of traditional cardiovascular risk factors and severity of CAD, multivariate analysis showed NAFLD to be associated with high-risk plaque (AOR=2.13; 95% CI, 1.18-3.85). NAFLD was further associated with a six-fold risk for acute coronary syndrome (OR=5.84; 95% CI, 2.58-13.22; P<.001).

“The additional assessment of NAFLD with CT could improve the risk stratification of patients with suspected coronary artery disease, as our results show that the presence of NAFLD is associated with high-risk coronary plaque independent of traditional risk factors and severity of coronary artery disease,” Puchner said in the release. “The aim will be to further investigate and understand, with the help of CCTA, the interplay between advanced atherosclerosis and NAFLD as part of a complex systemic inflammatory condition.”

Disclosure: The researchers report no relevant financial disclosures.