Fatty liver disease increases risk for impaired myocardial perfusion

Patients undergoing primary PCI for STEMI who present with moderate or severe fatty liver disease were more likely to have impairment of myocardial perfusion compared with patients with less severe disease, according to recent findings.

Researchers sought to determine the effect of nonalcoholic fatty liver disease (NAFLD) on myocardial perfusion and incidence of in-hospital MACE among 186 patients without diabetes (mean age, 58 years; 76% men). All participants had been diagnosed by ultrasound and were treated with PCI within 72 hours of hospital admission. Clinicians used a semiquantitative severity score to classify patients as having mild (score < 3) or moderate-severe (score ≥ 3) NAFLD. They measured myocardial blush grade and used ST-segment resolution analysis to determine myocardial perfusion.

Postprocedural TIMI 3 flow grade was 89% in the mild NAFLD group and 83% in the moderate-severe group (P = .201).

Absent myocardial perfusion was observed in 37% of patients in the moderate-severe group and 12% of patients with a mild fatty liver disease score (P < .0001). Absent ST-segment resolution analysis (27% vs. 9%; P = .001) and in-hospital MACE (31% vs. 8%; P < .0001) were also more common among patients with a more severe fatty liver disease score.

Results from multivariable analysis indicated that a fatty liver disease score of at least 3 independently predicted absent myocardial perfusion (OR = 2.856; 95% CI, 1.214-6.225), along with absent ST segment resolution analysis (OR = 2.862; 95% CI, 1.242-6.342) and in-hospital MACE (OR = 2.454; 95% CI, 1.072-4.872).

Researchers also observed significantly greater rates of in-hospital, nonfatal MI (P = .011) and death (P = .041) among patients with a fatty liver disease score of at least 3, along with a nonsignificant trend toward increased rates of acute HF (P = .054). Patients with more severe liver disease also had higher peak CK-MB levels (P = .002) and lower postprocedural left ventricular ejection fraction (P = .004).

“Patients with [fatty liver disease] score ≥ 3 are more likely to have impaired myocardial perfusion, which may contribute to adverse in-hospital outcome,” the researchers concluded. – by Rob Volansky

Disclosure: The researchers report no relevant financial disclosures.

Source: www.healio.com