eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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1/2024
vol. 20
 
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abstract:
Original paper

Evaluation of the non‑alcoholic fatty liver fibrosis score in predicting short-term outcomes and severe coronary artery disease in patients undergoing coronary computed tomography angiography

Esra Colak
1
,
Burak Acar
1
,
Ozgur Cakir
2
,
Umut Celikyurt
1
,
Ozgur Baris
3
,
Akın Torun
1
,
Mustafa Eren Tosun
1
,
Aysen Agir
1
,
Tayfun Sahin
1
,
Ercument Ciftci
2

  1. Department of Cardiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
  2. Department of Radiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
  3. Department of Cardiovascular Surgery, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
Adv Interv Cardiol 2024; 20, 1 (75): 45–52
DOI: https://doi.org/10.5114/aic.2024.136405
Online publish date: 2024/03/15
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Introduction:
The correlation between non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease is well established.

Aim:
The objective of this study was to assess the short-term associations of the non-alcoholic fatty liver disease fibrosis score (NFS) with various outcomes, including mortality, severe coronary artery disease, myocardial infarction, and the need for coronary angiography, among patients who underwent coronary computed tomographic angiography (CCTA).

Material and methods:
In this study, we assessed 499 patients who underwent 640-slice CCTA and evaluated their liver fibrosis using the NFS. The NFS takes into account factors such as age, body mass index, impaired fasting glycemia or diabetes mellitus, aspartate aminotransferase/alanine aminotransferase ratio, platelets, and albumin. Our primary focus was myocardial infarction, the need for coronary angiography, and death. Additionally, we examined the association between NFS and severe coronary artery disease.

Results:
Patients with a higher NFS had a greater number of coronary angiography procedures and higher Agatston score (p < 0.001), with NFS and Agatston score emerging as independent predictors of severe coronary artery disease and the primary endpoint. An NFS value above –0.92 could predict the primary endpoint with 61% sensitivity and 63% specificity, while an NFS value above –0.88 could predict severe coronary artery disease with 62% sensitivity and 65% specificity. To analyze primary endpoints, the Kaplan-Meier method was used for survival analysis, with NFS groups compared using the log-rank test. During the follow-up period, patients with higher NFS were exposed to primary outcomes at an earlier period (p = 0.009).

Conclusions:
NFS is an effective predictor of major cardiovascular events such as death, myocardial infarction, severe coronary artery disease, and the need for coronary angiography. These findings underscore the importance of NFS as a valuable tool for risk assessment and early intervention in patients with suspected or confirmed coronary artery disease.

keywords:

non-alcoholic fatty liver disease, coronary artery disease, coronary computed tomographic angiography, non-alcoholic fatty liver disease fibrosis score, cardiovascular outcomes
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