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Relationship of hepatic steatosis severity and coronary artery disease characteristics assessed by coronary CT angiography

  • Nobuo Tomizawa
  • Shinichi Inoh
  • Takeshi Nojo
  • Sunao Nakamura
Original Paper

Abstract

The objective of this study was to investigate the relationship between the severity of hepatic steatosis and coronary artery disease characteristics assessed by coronary computed tomography (CT) angiography. This retrospective analysis consisted of 2028 patients. Hepatic steatosis was evaluated by liver attenuation on unenhanced CT and the patients were divided into four groups (≥60 HU, 54–59 HU, 43–53 HU, ≤42 HU). Coronary calcification was calculated using the Agatston method. Obstructive disease was defined as ≥50 % stenosis assessed by CT. A high-risk plaque was defined by a remodeling index >1.1 and low attenuation (<30 HU). Patients with a segment involvement score >4 were determined to have extensive disease. Logistic regression analysis was performed to study multivariate associations. Severity of hepatic steatosis was associated with coronary calcification (p = 0.02), obstructive disease (p < 0.0001), presence of a high-risk plaque (p = 0.0001) and extensive disease (p = 0.001) in the univariate analysis. However, the relationships were attenuated in the multivariate analysis with the exception of obstructive disease (p = 0.04). Liver attenuation of <54 HU was significantly associated with obstructive coronary artery disease independent of conventional risk factors such as age, sex, diabetes mellitus, hypertension, dyslipidemia and smoking (hepatic attenuation 43–53 HU, odds ratio 1.52, 95 % confidence interval 1.11–2.10, p = 0.01; ≤42 HU, odds ratio 1.65, 95 % confidence interval 1.10–2.45, p = 0.02). Although conventional risk factors were stronger predictors of coronary calcification and plaque formation, the severity of hepatic steatosis remained an independent risk factor for obstructive coronary artery disease. Coronary CT angiography may play a potential role in risk stratification for patients with hepatic steatosis.

Keywords

Coronary artery disease Computed tomography angiography Hepatic steatosis 

Notes

Acknowledgments

This study was supported in part by a JSPS KAKENHI Grant No. (15H00648).

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Nobuo Tomizawa
    • 1
  • Shinichi Inoh
    • 1
  • Takeshi Nojo
    • 1
  • Sunao Nakamura
    • 2
  1. 1.Department of RadiologyNew Tokyo HospitalMatsudoJapan
  2. 2.Department of CardiologyNew Tokyo HospitalMatsudoJapan

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