Nonalcoholic fatty liver in nondiabetic patients with acute coronary syndromes
Version of Record online: 11 MAR 2013
© 2013 The Authors. European Journal of Clinical Investigation © 2013 Stichting European Society for Clinical Investigation Journal Foundation
European Journal of Clinical Investigation
Volume 43, Issue 5, pages 429–438, May 2013
How to Cite
Eur J Clin Invest 2013; 43 (5): 429–438
- Issue online: 17 APR 2013
- Version of Record online: 11 MAR 2013
- Manuscript Accepted: 10 FEB 2013
- Manuscript Received: 29 SEP 2012
- Acute coronary syndromes;
- metabolic syndrome;
- non alcoholic fatty liver disease;
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.
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.
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.