MACE Shows Independent Association With Hepatic Steatosis

Researchers have concluded that hepatic steatosis may be associated with a heightened risk of major adverse cardiovascular events (MACE) independently of pre-existing coronary artery disease, according to a recently published study.

The investigators conducted a nested cohort study of patients who underwent comprehensive contrast-enhanced computed tomography angiography (CTA) at 193 North American sites from July 2010 through September 2013. Of these 3756 participants in the PROMISE study, 48.4% were men and the mean age was 60.6 years.

In the course of the study, researchers used noncontrast computed tomography to identify steatosis, and evaluated coronary plaques and stenosis in coronary CTA images. They accumulated data on the body mass indices and cardiovascular risk factors among the participants and whether metabolic syndrome was present. The primary endpoint for this study was a composite of MACE, including myocardial infarction, unstable anginaq2a, or death, during the follow-up period 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),” the authors wrote. “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).”

They added, “Steatosis remained independently associated with MACE after adjustment for all CTA measures of plaques and stenosis. Strategies to reduce steatosis might reduce risk of MACE.”

--Rebecca Mashaw

Reference:

Meyersohn NM, Mayrhofer T, Corey, KE, et al. Association of hepatic steatosis with major adverse cardiovascular events, independent of coronary artery disease. Clin Gastroenterol Hepatol. 2021;19(7):1480-1488. DOI:https://doi.org/10.1016/j.cgh.2020.07.030