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Nonalcoholic fatty liver in nondiabetic patients with acute coronary syndromes
Author(s) -
Boddi Maria,
Tarquini Roberto,
Chiostri Marco,
Marra Fabio,
Valente Serafina,
Giglioli Cristina,
Gensini Gian F.,
Abbate Rosanna
Publication year - 2013
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12065
Subject(s) - medicine , metabolic syndrome , fatty liver , diabetes mellitus , waist , gastroenterology , body mass index , coronary artery disease , acute coronary syndrome , nonalcoholic fatty liver disease , myocardial infarction , risk factor , triglyceride , cardiology , disease , cholesterol , obesity , endocrinology
Background Growing evidence was collected that non‐alcoholic liver fatty disease ( NAFLD ) is a risk factor for coronary atherosclerosis in terms of angiographic appearance, but its involvement in acute coronary syndromes is still debated. We investigated the prevalence and severity of NAFLD in non‐diabetic patients admitted for ST ‐segment elevation myocardial infarction ( STEMI ) and its association with multi‐vessel coronary artery disease ( CAD ). Materials and methods Ninety‐five consecutive non‐diabetic patients admitted to cardiac ICU for STEMI were studied by ultrasound within 72 h from admission. NAFLD was graded according to a semi‐quantitative severity score as mild (score < 3) or moderate‐severe (> 3 score). Prevalence of cardiovascular ( CV ) risk factors, atherosclerotic burden markers and metabolic syndrome ( MS ) was investigated. Results The overall prevalence of NAFLD was 87%. Forty‐eight patients showed moderate‐severe NAFLD ( SFLD ). Thirty‐five patients showed mild NAFLD ( MLFD group) and 12 patients had no NAFLD . Patients with SFLD were younger and showed higher prevalence of multi‐vessel CAD (i.e. > 2) than patients with mild MFLD ( P < 0·01). Total cholesterol, triglycerides, body mass index and waist circumference were higher and HDL lower in SFLD than MFLD patients. About 50% of all NAFLD patients did not have MS . MS prevalence was higher in SFLD than MLFD patients ( P < 0·05) and among MS components, waist circumference and triglyceride levels showed the strongest association with SFLD ( P < 0·05). At logistic regression analysis, SFLD was independently associated with a three‐fold risk of multi‐vessel CAD . Conclusions In non‐diabetic patients admitted for STEMI NAFLD prevalence was very high. Severe NAFLD independently increased the risk for multi‐vessel CAD associated to CV events.