TY - JOUR
T1 - Hepatic steatosis evidenced by computed tomography in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction
AU - Fujito, Hidesato
AU - Fukamachi, Daisuke
AU - Ohgaku, Akihito
AU - Kojima, Keisuke
AU - Murata, Nobuhiro
AU - Yoda, Shunichi
AU - Saito, Yuki
AU - Yamada, Akimasa
AU - Koyama, Yutaka
AU - Arai, Riku
AU - Ebuchi, Yasunari
AU - Monden, Masaki
AU - Tamaki, Takehiro
AU - Kitano, Daisuke
AU - Okumura, Yasuo
N1 - Publisher Copyright:
© 2023 Elsevier Ltd
PY - 2023/11
Y1 - 2023/11
N2 - Background: Non-alcoholic fatty liver disease (NAFLD) and acute myocardial infarction (AMI) have common pathological links. This study investigates the prognostic impact of NAFLD assessed as hepatic steatosis (HS) by computed tomography (CT) in AMI patients and explores the mechanistic role of NAFLD in cardiovascular (CV) events using coronary angioscopy (CAS). Methods: We retrospectively examined 342 AMI patients who underwent CT followed by primary percutaneous coronary intervention (PCI) between January 2014 and December 2019. HS was defined as a hepatic to spleen attenuation ratio of <1.0 on CT scans. Major cardiac events (MCE) included cardiac death, non-fatal myocardial infarction, target-vessel revascularization, and target-lesion revascularization. Results: HS was identified in 88 patients (26 %). Patients with HS were significantly younger, had a higher body mass index, and higher hemoglobin A1c, triglyceride, and malondialdehyde low-density lipoprotein levels (all p < 0.05). MCE occurred more frequently [27 (30.7 %) vs. 39 (15.4 %), p = 0.001] in the HS group than in the non-HS group. In the multivariate analysis, the presence of HS was an independent predictor of MCE after adjusting for metabolic risk factor and liver function markers. Among the 74 patients who underwent CAS for a median of 15 days after primary PCI, 51 (69 %) had intrastent thrombus, which was strongly associated with the presence of HS [18 (35 %) vs. 1 (4 %), p = 0.005]. Conclusions: AMI patients with NAFLD detected by CT often had CAS-derived intrastent thrombi and were at a high risk for CV events. Therefore, these patients should be carefully monitored.
AB - Background: Non-alcoholic fatty liver disease (NAFLD) and acute myocardial infarction (AMI) have common pathological links. This study investigates the prognostic impact of NAFLD assessed as hepatic steatosis (HS) by computed tomography (CT) in AMI patients and explores the mechanistic role of NAFLD in cardiovascular (CV) events using coronary angioscopy (CAS). Methods: We retrospectively examined 342 AMI patients who underwent CT followed by primary percutaneous coronary intervention (PCI) between January 2014 and December 2019. HS was defined as a hepatic to spleen attenuation ratio of <1.0 on CT scans. Major cardiac events (MCE) included cardiac death, non-fatal myocardial infarction, target-vessel revascularization, and target-lesion revascularization. Results: HS was identified in 88 patients (26 %). Patients with HS were significantly younger, had a higher body mass index, and higher hemoglobin A1c, triglyceride, and malondialdehyde low-density lipoprotein levels (all p < 0.05). MCE occurred more frequently [27 (30.7 %) vs. 39 (15.4 %), p = 0.001] in the HS group than in the non-HS group. In the multivariate analysis, the presence of HS was an independent predictor of MCE after adjusting for metabolic risk factor and liver function markers. Among the 74 patients who underwent CAS for a median of 15 days after primary PCI, 51 (69 %) had intrastent thrombus, which was strongly associated with the presence of HS [18 (35 %) vs. 1 (4 %), p = 0.005]. Conclusions: AMI patients with NAFLD detected by CT often had CAS-derived intrastent thrombi and were at a high risk for CV events. Therefore, these patients should be carefully monitored.
KW - Computed tomography
KW - Coronary angioscopy
KW - Hepatic steatosis
KW - Myocardial infarction
KW - Percutaneous coronary intervention
UR - http://www.scopus.com/inward/record.url?scp=85161706685&partnerID=8YFLogxK
U2 - 10.1016/j.jjcc.2023.05.008
DO - 10.1016/j.jjcc.2023.05.008
M3 - Article
C2 - 37236437
AN - SCOPUS:85161706685
SN - 0914-5087
VL - 82
SP - 414
EP - 422
JO - Journal of Cardiology
JF - Journal of Cardiology
IS - 5
ER -