Title: A Correlation Study between Non-Alcoholic Fatty Liver Disease and Severity of Coronary Artery Disease

Authors: Dr Seba Brata Jana, Dr Kaushik Paul, Dr Bidyut Roy, Dr Sankar Chandra Mandal

 DOI: https://dx.doi.org/10.18535/jmscr/v8i4.30

Abstract

   

Introduction

According to the World Health Organization, the most common cause of death worldwide is cardiovascular disease (CVD) of which Ischaemic Heart disease stands high in the list.  Risk factors of IHD can be non-modifiable & modifiable factors The Modifiable factors are hypertension, smoking, dyslipidemia, diabetes, obesity, sedentary lifestyle & stress which always are the target areas for reducing the morbidity and mortality related to IHD. Non-alcoholic Fatty Liver Disease (NAFLD) may be considered a modifiable risk factor for IHD. Recently emerging evidences suggests that the incidence of Non-alcoholic Fatty Liver Disease (NAFLD) is high among patients of Coronary Artery Disease(CAD) in comparison to general population, and this  association is independent of other metabolic risk factors of IHD, and cardiovascular disease is the most important cause of death in patients suffering from NAFLD (1,2).So identifying NAFLD in early stage and proper management may help in reducing the future risk of CAD and thus reducing the morbidity and mortality related to CAD. There are evidences in literature that shows the association between NAFLD and Coronary Artery Disease (CAD) but no enough evidences so far to prove causal relationship. This study we conducted to estimate the prevalence of NAFLD as diagnosed by ultrasonographic examination of the liver and to assess the association between NAFLD and CAD and to find if there is any correlation between severity of CAD with NAFLD. We used coronary angiography to assess the presence of CAD. While assessing coronary angiography we calculated SYNTAX score to estimate anatomical complexity of CAD and as a marker of severity of CAD. In Patients with NAFLD, we also assessed severity by grading of fatty liver with USG criteria and by stiffness of liver using Fibroscan. We tried to found out any association with grades of severity fatty liver with severity of CAD.

References

  1. Lonardo A, Sookoian S, Pirola CJ, Targher G. Non-alcoholic fatty liver disease and risk of cardiovascular disease. 2016;65(8):1136-50.
  2. Ballestri S, Lonardo A, Bonapace S, Byrne CD, Loria P, Targher G. Risk of cardiovascular, cardiac and arrhythmic complications in patients with non-alcoholic fatty liver disease. World J Gastroenterol. 2014;20(7):1724–45.
  3. Younossi Z, Anstee Q, Marietti M, Hardy T, Henry L, Eslam M et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nature Reviews Gastroenterology & Hepatology. 2017;15(1):11-20.
  4. . Das K, Das K, Mukherjee P, Ghosh A, Ghosh S, Mridha A et al. Nonobese population in a developing country has a high prevalence of nonalcoholic fatty liver and significant liver disease. Hepatology. 2010;51(5):1593-1602.
  5. Amarapurkar D, Kamani P, Patel N, Gupte P, Kumar P, Agal S et al. Prevalence of non-alcoholic fatty liver disease: population based study. Annals of Hepatology. 2007;6(3):161-163.
  6. Tahmineh Tavakoli, Toba Kazemi, Homa Mollaei, Fatemeh Salmani, Samira Saghafi, Ensiah Sadat Mousavi, Mahyar Mohamadifard and  Gholamreza Sharifzadeh. The Relationship Between the Prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) with the Severity of Coronary Artery Disease (CAD) in Patients Undergoing Coronary Artery Angiography: A Cross- Sectional Study. Iran Red Crescent Med J. 2018 June; 20(6):e58369.

Corresponding Author

Dr Kaushik Paul

SSKM Doctor’s Hostel, IPGMER And SSKM Hospital, Kolkata 700020, India