Association of Hepatic Steatosis With Major Adverse Cardiovascular Events, Independent of Coronary Artery Disease.
Association of Hepatic Steatosis With Major Adverse Cardiovascular Events, Independent of Coronary Artery Disease.
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肝脂肪变性与主要不良心血管事件的关联，与冠状动脉疾病无关。
DOI：
10.1016/j.cgh.2020.07.030
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Ferencik M
中科院分区：
文献类型：
--
作者：
Meyersohn NM;Mayrhofer T;Corey KE;Bittner DO;Staziaki PV;Szilveszter B;Hallett T;Lu MT;Puchner SB;Simon TG;Foldyna B;Voora D;Ginsburg GS;Douglas PS;Hoffmann U;Ferencik M
肝脏脂肪变性与主要不良心血管事件 (MACE) 风险增加相关，但尚不清楚脂肪变性是否与 MACE 风险独立相关。我们研究了脂肪变性是否与 MACE 风险相关，与基线冠状动脉疾病的存在和程度无关，并通过综合对比增强计算机断层扫描血管造影 (CTA) 进行评估。作为 PROMISE 研究的一部分，我们对 3756 名受试者（平均年龄 60.6 岁；48.4% 男性）进行了一项巢式队列研究，这些受试者从 2010 年 7 月到 2013 年 9 月在北美 193 个地点接受了冠状动脉 CTA，其中包括对没有冠状动脉疾病的症状门诊患者进行无创心血管分析。独立核心实验室读者测量肝脏和脾脏的衰减，使用非对比计算机断层扫描图像来识别脂肪变性，并评估冠状动脉 CTA 图像中的冠状动脉斑块和狭窄。我们收集了参与者的心血管危险因素、代谢综合征的存在和体重指数的数据。主要终点是中位随访时间 25 个月期间判定的 MACE（死亡、心肌梗死或不稳定型心绞痛）复合终点。在 959 名患有脂肪变性的受试者中（占队列的 25.5%），42 名患有 MACE（4.4%），而在 2797 名无脂肪变性受试者中，73 名患有 MACE（2.6%）（脂肪变性受试者中 MACE 的风险比 [HR]，1.69；95% CI，1.16–2.48；有脂肪变性受试者与无脂肪变性受试者中 MACE 的 P=.006脂肪变性）。在调整动脉粥样硬化性心血管疾病风险评分、显着狭窄和代谢综合征（调整后 HR，1.72；95% CI，1.16-2.54；P=0.007）或肥胖（调整后 HR，1.75；95% CI，1.19-2.59；P=0.005）后，这种相关性仍然存在。在调整斑块和狭窄的所有 CTA 测量值后，脂肪变性仍然与 MACE 独立相关。肝脂肪变性与 MACE 相关，与其他心血管危险因素或冠状动脉疾病的程度无关。减少脂肪变性的策略可能会降低 MACE 的风险。 ClinicalTrials.gov 编号：NCT01174550
Hepatic steatosis has been associated with increased risk of major adverse cardiovascular events (MACE) but it is not clear whether steatosis is independently associated with risk of MACE. We investigated whether steatosis is associated with risk of MACE independently of the presence and extent of baseline coronary artery disease, assessed by comprehensive contrast-enhanced computed tomography angiography (CTA). We conducted a nested cohort study of 3756 subjects (mean age, 60.6 years; 48.4% men) who underwent coronary CTA at 193 sites in North America, from July 2010 through September 2013, as part of the PROMISE study, which included noninvasive cardiovascular analyses of symptomatic outpatients without coronary artery disease. Independent core laboratory readers measured hepatic and splenic attenuation, using non-contrast computed tomography images to identify steatosis, and evaluated coronary plaques and stenosis in coronary CTA images. We collected data on participants’ cardiovascular risk factors, presence of metabolic syndrome, and body mass index. The primary endpoint was an adjudicated composite of MACE (death, myocardial infarction, or unstable angina) during a median follow-up time of 25 months. Among the 959 subjects who had steatosis (25.5% of the cohort), 42 had MACE (4.4%), whereas among the 2797 subjects without steatosis, 73 had MACE (2.6%) (hazard ratio [HR] for MACE in subjects with steatosis, 1.69; 95% CI, 1.16–2.48; P=.006 for MACE in subjects with vs without steatosis). This association remained after adjustment for atherosclerotic cardiovascular disease risk scores, significant stenosis, and metabolic syndrome (adjusted HR, 1.72; 95% CI, 1.16–2.54; P=.007) or obesity (adjusted HR, 1.75; 95% CI, 1.19–2.59; P=.005). Steatosis remained independently associated with MACE after adjustment for all CTA measures of plaques and stenosis. Hepatic steatosis is associated with MACE independently of other cardiovascular risk factors or extent of coronary artery disease. Strategies to reduce steatosis might reduce risk of MACE. ClinicalTrials.gov no: NCT01174550
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非酒精性脂肪肝病与冠状动脉钙化有关。
影响因子：
13.5
作者：
Kim, Donghee;Choi, Su-Yeon;Park, Eun Ha;Lee, Whal;Kang, Jin Hwa;Kim, Won;Kim, Yoon Jun;Yoon, Jung-Hwan;Jeong, Sook Hyang;Lee, Dong Ho;Lee, Hyo-suk;Larson, Joseph;Therneau, Terry M.;Kim, W. Ray
通讯作者：
Kim, W. Ray
DOI：
10.1136/bmj.d6891
发表时间：
2011-11-18
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Lazo M;Hernaez R;Bonekamp S;Kamel IR;Brancati FL;Guallar E;Clark JM
通讯作者：
Clark JM
影响因子：
13.5
作者：
Kim, Donghee;Kim, W. Ray;Kim, Hwa Jung;Therneau, Terry M.
通讯作者：
Therneau, Terry M.
影响因子：
4.2
作者：
Ishiba, Hiroshi;Sumida, Yoshio;Itoh, Yoshito
通讯作者：
Itoh, Yoshito
影响因子：
3
作者：
Guo, Kaifeng;Zhang, Lei;Jia, Weiping
通讯作者：
Jia, Weiping