IDDF2018-ABS-0219 Assessment of correlation between non-alcoholic fatty liver disease and severity of coronary artery disease in young acute coronary syndrome patients

Alyaa Hassan Ali,Raja Affendi Raja Ali,Ngiu Chai Soon,Shawal Mohamed Faizal,Nur Yazmin Yaacob,Hamad Hamdi Che Hassan,Khairul Najmi Muhammad Nawawi,Wong Zhiqin,Oteh Maskon,Shamsul Azhar Shah

doi:10.1136/gutjnl-2018-iddfabstracts.235

Alyaa Hassan Ali, Raja Affendi Raja Ali + Show 8 more

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https://doi.org/10.1136/gutjnl-2018-iddfabstracts.235

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Abstract

Background Coronary artery disease (CAD), which clinically manifested as an acute coronary syndrome (ACS) is an important extrahepatic cardiovascular complication of non-alcoholic fatty liver disease (NAFLD). To date, little is known about the correlation between young patients with ACS and NAFLD. Aim to assess the correlation between NAFLD and severity of CAD in young ACS patients and determine the prevalence of NAFLD in this cohort. Methods This cross-sectional study included young (45 years and less) ACS patients. Coronary angiogram was performed to assess CAD severity, and complexity determined by SYNTAX score. CAD severity was classified into: no apparent CAD, mild CAD, single vessel disease (SVD) and multi-vessel disease (MVD). Liver ultrasound was used to diagnose and grade the NAFLD (grade 1–3). NAFLD fibrosis score (NFS) was calculated, and patients were stratified to low, indeterminate, and high probability for advanced liver fibrosis. Results Total of 85 patients with median age of 40 years (IQR 35–43) and predominated by males (84.7%). Thirty-three (38.9%) had ST elevation myocardial infarction (STEMI), 32 (37.6%) had Non-STEMI and 20 (23.5%) had unstable angina. MVD was demonstrated in 36.5%, SVD in 24.7%, mild CAD in 31.8%, and no apparent CAD in 7.1% of the patients. Median Syntax score was 16 (IQR 9.0–22.3). NAFLD was diagnosed in all, 85 (100%) patients, with 13 (15.2%), 36 (42.4%) and 36 (42.2%) patients had grade 1, 2 and 3 liver steatosis respectively. NFS detected low advanced fibrosis probability in 60 (70.6%) patients, indeterminate probability in 24 (28.2%) patients and high probability in only 1 (1.2%) patient. No significant correlation between grades of NAFLD with ACS subtypes (p=0.72), severity of CAD (p=0.882) and SYNTAX score (p=0.982). No significant association between NFS and ACS subtypes (p=0.232), severity of CAD (p=0.445) and SYNTAX score (p=0.624, r=0.07). Conclusions NAFLD is highly prevalent in young patients presented with ACS, and it should be routinely screened in our clinical practice. However, in a small cohort, we observed no significant correlation between severity of NAFLD and severity of CAD among young ACS patients.

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