| Autor: |
Keishi Ichikawa, Spencer Hansen, Venkat S. Manubolu, Leili Pourafkari, Hooman Fazlalizadeh, Jairo Aldana-Bitar, Lisa B VanWagner, Srikanth Krishnan, Matthew J. Budoff |
| Rok vydání: |
2023 |
| DOI: |
10.1101/2023.02.20.23286213 |
| Popis: |
BackgroundNonalcoholic fatty liver disease (NAFLD) is associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD) events, thus a diagnostic approach to help identify NAFLD patients at high risk is needed. In this study, we hypothesized that coronary artery calcium (CAC) screening could help stratify the risk of ASCVD events in NAFLD patients.MethodsA total of 718 NAFLD participants from Multi-Ethnic Study of Atherosclerosis (MESA) without previous cardiovascular events were followed for the occurrence of incident ASCVD. NAFLD was defined using non-enhanced computed tomography and liver/spleen attenuation ratio ResultsIn multivariable analyses, CAC score was found to be independently associated with incident ASCVD (HR = 1.33, 95% CI = 1.22–1.44, p < 0.001). The addition of CAC score to clinical risk factors increased the C-statistic from 0.677 to 0.739 (p < 0.001) and the net reclassification index was 0.721 (95% CI = 0.494–0.977). In subgroup analyses, the incremental prognostic value of CAC score was more significant in NAFLD participants with low/borderline- (ConclusionsThe inclusion of CAC score in global risk assessment was found to significantly improve the classification of incident ASCVD events in participants with NAFLD, indicating a potential role for CAC screening in risk assessment.Clinical PerspectiveWith the increasing prevalence of nonalcoholic fatty liver disease (NAFLD) individuals, there is an unmet need for a diagnostic approach to identify NAFLD individuals who are at higher risk for atherosclerotic cardiovascular disease (ASCVD) events. This study showed that higher coronary artery calcium (CAC) score was associated with ASCVD events during follow-up and improved the discriminative ability for future events in NAFLD individuals. Our study suggests routine CAC screening can be useful in assessing the risk of future ASCVD events. Future studies are needed to explore the therapeutic implications of CAC screening in this population. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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