Coronary Artery Disease and Major Adverse Cardiovascular Events in People With Hepatic Steatosis at Low Atherosclerotic Cardiovascular Disease Risk.

IF 6.6 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Alimentary Pharmacology & Therapeutics Pub Date : 2025-02-01 Epub Date: 2024-11-29 DOI:10.1111/apt.18415

Julia Karady, Thomas Mayrhofer, Borek Foldyna, Michael T Lu, Nandini Meyersohn, Udo Hoffmann, Oluwafemi Balogon, Neha Pagidipati, Svati Shah, Pamela S Douglas, Maros Ferencik, Kathleen Corey

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引用次数: 0

Abstract

Background: Hepatic steatosis (HS) and 10-year atherosclerotic cardiovascular disease (ASCVD) risk ≥ 7.5% are associated with increased risk for cardiovascular events.

Aim: To assess underlying coronary artery disease (CAD) and major adverse cardiovascular event (MACE) among those with and without HS at different ASCVD risk.

Methods: We evaluated stable chest pain patients receiving coronary computed tomography (CT) in the PROMISE trial. HS and CAD endpoints were defined on coronary CT. MACE was defined as unstable angina, non-fatal myocardial infarction, and all-cause death. Multivariable Cox regression, adjusting for CAD characteristics, assessed the association of HS with MACE for ASCVD < 7.5%.

Results: One thousand two hundred and four of 3702 (32.5%) patients were at ASCVD < 7.5% and 20.3% (244/1204) of them had HS. Individuals with HS were younger (54.3 ± 5.2 vs. 55.8 ± 5.2; p < 0.001), more often males (40.2% [98/244] vs. 27.1% [260/960]; p < 0.001), had more risk factors/person (2.06 ± 0.89 vs. 1.93 ± 0.91; p = 0.047). CAD characteristics were similar between HS vs. non-HS patients at ASCVD < 7.5% and ASCVD ≥ 7.5% (all p > 0.05). Patients with HS had greater MACE rate compared to non-HS patients (ASCVD < 7.5%: 3.75%[9/244] vs. 1.5% [14/960]; p = 0.027 and ASCVD ≥ 7.5%: 4.7% [33/696] vs. 3.1% [56/1802]; p = 0.043). In patients without HS, MACE rate was higher in the ASCVD ≥ 7.5% vs. < 7.5% (3.1% [56/1802] vs. 1.5% [14/960]; p = 0.011). In patients with HS, MACE rates were not significantly different between ASCVD ≥ 7.5% vs. < 7.5% (4.7% [33/696] vs. 3.7% [9/244]; p = 0.484). In ASCVD < 7.5%, HS predicted MACE (aHR:2.34, 95%CI:1.01-5.43; p = 0.048), independent of CAD characteristics.

Conclusions: Individuals with HS at ASCVD < 7.5% risk had similar CAD characteristics as patients without HS at < 7.5% ASCVD risk, yet experienced comparable MACE rates as those at ASCVD ≥ 7.5%.

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低动脉粥样硬化性心血管疾病风险的肝脂肪变性患者的冠状动脉疾病和主要不良心血管事件

背景：肝脂肪变性（HS）和10年动脉粥样硬化性心血管疾病（ASCVD）风险≥7.5%与心血管事件风险增加相关。目的：评估不同ASCVD风险的HS患者和非HS患者的潜在冠状动脉疾病（CAD）和主要心血管不良事件（MACE）。方法：我们在PROMISE试验中评估接受冠状动脉计算机断层扫描（CT）的稳定型胸痛患者。在冠状动脉CT上确定HS和CAD终点。MACE定义为不稳定型心绞痛、非致死性心肌梗死和全因死亡。多变量Cox回归，调整CAD特征，评估HS与MACE与ASCVD的关系。结果：3702例患者中有124例（32.5%）ASCVD为0.05。与非HS患者相比，HS患者的MACE率更高

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alimentary Pharmacology & Therapeutics 医学-胃肠肝病学

CiteScore

15.60

自引率

7.90%

发文量

527

审稿时长

3-6 weeks

期刊介绍： Alimentary Pharmacology & Therapeutics is a global pharmacology journal focused on the impact of drugs on the human gastrointestinal and hepato-biliary systems. It covers a diverse range of topics, often with immediate clinical relevance to its readership.