Abstract 10344: Impact of Non-alcoholic Fatty Liver on Vulnerable Plaques Evaluated by MDCT Angiography
Background: Non-alcoholic fatty liver disease (NAFLD) is strongly associated with obesity, type 2 diabetes mellitus (DM) and dyslipidemia and overlaps risk factors of CAD. Moreover, NAFLD has been recently reported as an independent risk factor of atherosclerosis. The aim of this study was to investigate the association between NAFLDand the presence of vulnerable plaques and characteristics of coronary artery plaques using 64 slice computed tomography angiography (MDCT).
Methods: A total of 414 consecutive patients (51% male, age 64±15 years) with suspected CAD were evaluated. NAFLD were defined by CT as the ratio of hepatic attenuation to spleen attenuation less than 1.0. and excluded patients with history of an alcohol intake of more than 20g per day or known liver disease, current use of oral steroids and/or class IIIantiarrhythmics.
Results: 61 (15%) patients had vulnerable plaquescharacterized by low density plaque, positive remodeling and spotty calcification.
The prevalence of NAFLD in patients having vulnerable plaques were significantly greater than that in patients without vulnerable plaques(n=22; 36%; vs. n=42; 12% p<0.01).Compared patients without NAFLD, patients with NAFLDwere likely to have more non calcified plaque (50% vs 67%, p=0.013), positive remodeling appearance (41% vs 58%, p=0.012), low density plaque (21% vs 44%, p<0.001), spotty calcification (12% vs 36%, p<0.001) and vulnerable plaque morphology(11% vs 34%, p<0.001).
In multivariate analysis, NAFLD was independently associated with presence of vulnerable plaques(odds ratio [OR]: 4.62; 95% confidence interval [CI]: 2.12-10.11, p<0.01) after adjustment of age, gender, hypertension, dyslipidemia, DM, current smoking, medications and visceral adipose tissue.
Conclusion: NAFLD was strongly associated with vulnerable plaque independent of traditional risk factors of CAD. NAFLD could have incremental value for risk assessment of CAD.
- © 2013 by American Heart Association, Inc.