Influence of chronic liver disease on coronary atherosclerosis vulnerability features.
BACKGROUND
A lower incidence of acute myocardial infarction was reported in patients with chronic liver disease.


OBJECTIVE
To analyze the impact of chronic liver disease on characteristics associated with vulnerability of human coronary artery atherosclerotic plaques.


METHODS
One hundred fourteen hearts were collected from 3 groups of individuals: A--38 chronic liver disease patients who died while on the waiting list for liver transplantation; B--38 individuals who died of natural causes; and C--38 individuals who died of accidental causes. The most obstructed portion of the initial 2-cm segment of coronary arteries was histologically evaluated regarding to plaque area, luminal area, inflammation, percentage of fat, and total vessel area.


RESULTS
The mean age (years) and male frequency in groups A, B and C were, respectively, 52+/-9 and 79%; 52+/-11 and 71%; and 54+/-18 and 89%. The mean area of the plaque and the incidence of severe plaque inflammation in group A were significantly lower (4.2+/-3.2; 13.2%) than those in the other two groups (6.6+/-4.3; 84.2%, and 6.3+/-4.4; 52.6%) p<0.01. The cross-sectional vessel measures were not statistically different regarding to vessel area (10.5+/-4.6; 12.1+/-4.6; 13.0+/-4.4) p=0.08, luminal obstruction (45%+/-15%; 60%+/-20%; 53%+/-20%) p=0.07, and fat area in the plaque (16%+/-17%; 30%+/-24%; 18%+/-18) p=0.37. In conclusion, compared with the general population, chronic liver disease patients have coronary arteries with smaller intimal plaque and less vessel inflammation. These findings favor the concept that hepatic disease patients are less prone to develop complicated coronary atherosclerosis.
Otsubo
Roberto
R
Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, Brazil.
Higuchi
Maria de Lourdes
Mde L
Gutierrez
Paulo Sampaio
PS
Benvenuti
Luiz Alberto
LA
Massarollo
Paulo Celso Bosco
PC
Costa
Anderson Lino
AL
Ramires
José Antonio Franchini
JA
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000209:etiology*; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D008077:Lipoproteins, LDL / Q000378:metabolism; D008107:Liver Diseases / Q000473:pathology*; D008297:Male; D008875:Middle Aged
D008077:Lipoproteins, LDL