Impact of Nonalcoholic Fatty Liver Disease on Myocardial Perfusion in Nondiabetic Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction.
Limited data exist on the role of nonalcoholic fatty liver disease (FLD) as a potential independent risk factor in the setting of acute coronary syndromes. The aim of this study was to evaluate the impact of FLD on myocardial perfusion and inhospital major adverse cardiac events (MACE) in the setting of ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). We examined 186 consecutive nondiabetic patients (mean age 58 ± 11 years and 76% men) who underwent primary PCI for STEMI by ultrasound within 72 hours of admission. FLD was graded according to a semiquantitative severity score as mild (score <3) or moderate to severe (score ≥3). Myocardial perfusion was determined by measuring myocardial blush grade (MBG) and ST-segment resolution (STR) analysis. Patients were divided into 2 groups according to FLD score (<3 or ≥3). There were no differences with regard to postprocedural Thrombolysis In Myocardial Infarction 3 flow grade between the 2 groups (89% vs 83%, p = 0.201). Patients with FLD score ≥3 were more likely to have absent myocardial perfusion (MBG 0/1, 37% vs 12%, p <0.0001), absent STR (27% vs 9%, p = 0.001), and higher inhospital MACE rate (31% vs 8%, p <0.0001). By multivariate analysis, FLD ≥3 score was found to be an independent predictor of absent MBG 0/1 (odds ratio [OR] 2.856, 95% confidence interval [CI] 1.214 to 6.225, p = 0.033), absent STR (OR 2.862, 95% CI 1.242 to 6.342, p = 0.031), and inhospital MACE (OR 2.454, 95% CI 1.072 to 4.872, p = 0.048). In conclusion, we found that despite similar high rates of Thrombolysis In Myocardial Infarction 3 after primary PCI, patients with FLD score ≥3 are more likely to have impaired myocardial perfusion which may contribute to adverse inhospital outcome.
Department of cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey. Electronic address: dremreayse@gmail.com.
Ayse
A
Emre
Department of cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
Sait
S
Terzi
Department of cardiology, Adana Numune Research and Training Hospital, Adana, Turkey.
Emel
E
Celiker
Department of cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
Sinan
S
Sahin
Department of cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
Selcuk
S
Yazıcı
Department of cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
Aysun
A
Erdem
Department of cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
Ufuk Sadik
US
Ceylan
Department of Radiology, Medeniyet University Goztepe Research and Training Hospital, Istanbul, Turkey.
Murat
M
Asik
Department of cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
Kemal
K
Yesilcimen
D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications*; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D012307:Risk Factors