title: Relationship of hepatic steatosis severity and coronary artery disease characteristics assessed by coronary CT angiography.
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.
authors.affiliation: Department of Radiology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan. tomizawa-tky@umin.ac.jp.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Tomizawa
authors.affiliation: Department of Radiology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Inoh
authors.affiliation: Department of Radiology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nojo
authors.affiliation: Department of Cardiology, New Tokyo Hospital, Matsudo, Japan.
authors.forename: Sunao
authors.initials: S
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D000072226:Computed Tomography Angiography / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D061205:Vascular Calcification / Q000000981:diagnostic imaging* / Q000209:etiology
chemical_list: D003287:Contrast Media
keywords: Computed tomography angiography; Coronary artery disease; Hepatic steatosis
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