Introduction Risk factors for non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease overlap. This study aims to investigate the association between NAFLD and cardiovascular disease in patients undergoing computed tomography coronary angiography (CTCA) in the Scottish Computed Tomography of the Heart (SCOT-HEART) trial.
Methods The liver was assessed on non-contrast CT images from patients undergoing CTCA as part of the SCOT-HEART trial. Liver attenuation within a region of interest was used to predict the presence of potential NAFLD. Potential NAFLD was defined as a liver attenuation density <48 Hounsfield units (HU)).
Results The images from 820 patients were assessed. Patients had a mean age of 58±10 years and 54% were male. On non-contrast CT 26% (n=209) had potential NAFLD. Patients with potential NAFLD were more likely to have diabetes (p<0.001), hypertension (p=0.002), had a higher body mass index (p<0.001) and higher cardiovascular risk score (p=0.043). Patients with potential NAFLD had a higher coronary artery calcium score (6 (interquartile range (IQR) 0, 150) vs 39 (IQR 0,290), p=0.001) and were more likely to have non-obstructive CAD (45% vs 33%, p=0.003) but not obstructive CAD (29% vs 24%, p=0.165) Presence of CAD and raised BMI were independently associated with NAFLD on multivariate analysis.
Conclusion CT features of potential NAFLD are associated with the presence of CAD in patients undergoing investigation for suspected CAD.
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