Patients with Nonalcoholic Fatty Liver Disease May Warrant Additional CV Risk Assessment

Researchers at Massachusetts General Hospital and Harvard Medical School in Boston reviewed data from the Rule Out Myocardial Infarction using Computer Assisted Tomography (ROMICAT) II Trial to expand on the knowledge linking inflammation to atherosclerosis and see if there was an association between nonalcoholic fatty liver disease (NAFLD) and high-risk plaques.   Of the 445 patients included in this study, 59.3% of patients with NAFLD had high-risk plaques as compared to only 19% without NAFLD (P <0.001).  Even after adjusting for the extent and severity of coronary artery disease and traditional risk factors, there was an independent association between NAFLD and advanced high-risk plaques.  The authors discuss the complex issues related to the pathology between advanced coronary atherosclerosis and NAFLD and suggest it may include increases in oxidative stress, dysregulated cytokines, and/or systemic inflammation.  Additional assessment for cardiovascular risk appears to be warranted in patients with NAFLD.

Reference:  Puchner SB, et al. High risk coronary plaque at coronary CT angiography is associated with nonalcoholic fatty liver disease, independent of coronary plaque and stenosis burden: Results from the ROMICAT II trial.  Radiology 2014. Doi:

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