title: Nonalcoholic fatty liver in nondiabetic patients with acute coronary syndromes.
abstract: BACKGROUND
  Growing evidence was collected that non-alcoholic liver fatty disease (NAFLD) is a risk factor for coronary atherosclerosis in terms of angiographic appearance, but its involvement in acute coronary syndromes is still debated. We investigated the prevalence and severity of NAFLD in non-diabetic patients admitted for ST-segment elevation myocardial infarction (STEMI) and its association with multi-vessel coronary artery disease (CAD).
  
  
  METHODS
  Ninety-five consecutive non-diabetic patients admitted to cardiac ICU for STEMI were studied by ultrasound within 72 h from admission. NAFLD was graded according to a semi-quantitative severity score as mild (score < 3) or moderate-severe (> 3 score). Prevalence of cardiovascular (CV) risk factors, atherosclerotic burden markers and metabolic syndrome (MS) was investigated.
  
  
  RESULTS
  The overall prevalence of NAFLD was 87%. Forty-eight patients showed moderate-severe NAFLD (SFLD). Thirty-five patients showed mild NAFLD (MLFD group) and 12 patients had no NAFLD. Patients with SFLD were younger and showed higher prevalence of multi-vessel CAD (i.e. > 2) than patients with mild MFLD (P < 0·01). Total cholesterol, triglycerides, body mass index and waist circumference were higher and HDL lower in SFLD than MFLD patients. About 50% of all NAFLD patients did not have MS. MS prevalence was higher in SFLD than MLFD patients (P < 0·05) and among MS components, waist circumference and triglyceride levels showed the strongest association with SFLD (P < 0·05). At logistic regression analysis, SFLD was independently associated with a three-fold risk of multi-vessel CAD.
  
  
  CONCLUSIONS
  In non-diabetic patients admitted for STEMI NAFLD prevalence was very high. Severe NAFLD independently increased the risk for multi-vessel CAD associated to CV events.
authors.affiliation: Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy. maria.boddi@unifi.it
authors.forename: Maria
authors.initials: M
authors.lastname: Boddi
authors.forename: Roberto
authors.initials: R
authors.lastname: Tarquini
authors.forename: Marco
authors.initials: M
authors.lastname: Chiostri
authors.forename: Fabio
authors.initials: F
authors.lastname: Marra
authors.forename: Serafina
authors.initials: S
authors.lastname: Valente
authors.forename: Cristina
authors.initials: C
authors.lastname: Giglioli
authors.forename: Gian F
authors.initials: GF
authors.lastname: Gensini
authors.forename: Rosanna
authors.initials: R
authors.lastname: Abbate
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications* / Q000000981:diagnostic imaging; D000368:Aged; D003324:Coronary Artery Disease / Q000209:etiology; D005234:Fatty Liver / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000000981:diagnostic imaging; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D012307:Risk Factors; D012720:Severity of Illness Index; D014463:Ultrasonography