Acute Coronary Syndromes and Nonalcoholic Fatty Liver Disease: “Un Affaire de Coeur”
Background and Aims. Both nonalcoholic fatty liver disease (NAFLD) and ischemic heart disease have common pathogenic links. Evidence for the association of NAFLD with acute coronary syndromes (ACS), complex multivessel coronary artery disease (CAD), and increased mortality risk in ACS patients is st...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2020/8825615 |
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| author | Abdulrahman Ismaiel Stefan-Lucian Popa Dan L. Dumitrascu |
| author_facet | Abdulrahman Ismaiel Stefan-Lucian Popa Dan L. Dumitrascu |
| author_sort | Abdulrahman Ismaiel |
| collection | DOAJ |
| description | Background and Aims. Both nonalcoholic fatty liver disease (NAFLD) and ischemic heart disease have common pathogenic links. Evidence for the association of NAFLD with acute coronary syndromes (ACS), complex multivessel coronary artery disease (CAD), and increased mortality risk in ACS patients is still under investigation. Therefore, we conducted a systematic review aiming to clarify these gaps in evidence. Methods. We conducted a systematic search on PubMed and EMBASE with predefined keywords searching for observational studies published till August 2020. NAFLD diagnosis was accepted if confirmed through biopsy, imaging techniques, surrogate markers, or codes. Full articles that satisfied our inclusion and exclusion criteria were included in the systematic review. We used the NHLBI quality assessment tool to evaluate included studies. Results. Seventeen observational studies with a total study population of approximately 21 million subjects were included. Eleven studies evaluated whether NAFLD is an independent risk factor for developing ACS with conflicting results, of which eight studies demonstrated a significant association between NAFLD and ACS, mainly in Asian populations, while three reported a lack of an independent association. Conflicting results were reported in studies conducted in Europe and North America. Moreover, a total of five studies evaluated whether NAFLD and fatty liver severity in ACS patients are associated with a complex multivessel CAD disease, where all studies confirmed a significant association. Furthermore, seven out of eight studies evaluating NAFLD and hepatic steatosis severity as a predictor of all-cause and cardiovascular mortality and in-hospital major adverse cardiovascular events (MACE) in ACS patients demonstrated a significant independent association. Conclusions. NAFLD patients are associated with an independently increased risk of developing ACS, mainly in Asian populations, with inconsistent results in North American and European individuals. Moreover, NAFLD and hepatic steatosis severity were both independently correlated with complex multivessel CAD, mortality, and in-hospital MACE in ACS patients. |
| format | Article |
| id | doaj-art-4dffed5fbf274320abe9ce227d6305a8 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-4dffed5fbf274320abe9ce227d6305a82025-02-03T01:01:26ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972020-01-01202010.1155/2020/88256158825615Acute Coronary Syndromes and Nonalcoholic Fatty Liver Disease: “Un Affaire de Coeur”Abdulrahman Ismaiel0Stefan-Lucian Popa1Dan L. Dumitrascu22nd Department of Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania2nd Department of Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania2nd Department of Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, RomaniaBackground and Aims. Both nonalcoholic fatty liver disease (NAFLD) and ischemic heart disease have common pathogenic links. Evidence for the association of NAFLD with acute coronary syndromes (ACS), complex multivessel coronary artery disease (CAD), and increased mortality risk in ACS patients is still under investigation. Therefore, we conducted a systematic review aiming to clarify these gaps in evidence. Methods. We conducted a systematic search on PubMed and EMBASE with predefined keywords searching for observational studies published till August 2020. NAFLD diagnosis was accepted if confirmed through biopsy, imaging techniques, surrogate markers, or codes. Full articles that satisfied our inclusion and exclusion criteria were included in the systematic review. We used the NHLBI quality assessment tool to evaluate included studies. Results. Seventeen observational studies with a total study population of approximately 21 million subjects were included. Eleven studies evaluated whether NAFLD is an independent risk factor for developing ACS with conflicting results, of which eight studies demonstrated a significant association between NAFLD and ACS, mainly in Asian populations, while three reported a lack of an independent association. Conflicting results were reported in studies conducted in Europe and North America. Moreover, a total of five studies evaluated whether NAFLD and fatty liver severity in ACS patients are associated with a complex multivessel CAD disease, where all studies confirmed a significant association. Furthermore, seven out of eight studies evaluating NAFLD and hepatic steatosis severity as a predictor of all-cause and cardiovascular mortality and in-hospital major adverse cardiovascular events (MACE) in ACS patients demonstrated a significant independent association. Conclusions. NAFLD patients are associated with an independently increased risk of developing ACS, mainly in Asian populations, with inconsistent results in North American and European individuals. Moreover, NAFLD and hepatic steatosis severity were both independently correlated with complex multivessel CAD, mortality, and in-hospital MACE in ACS patients.http://dx.doi.org/10.1155/2020/8825615 |
| spellingShingle | Abdulrahman Ismaiel Stefan-Lucian Popa Dan L. Dumitrascu Acute Coronary Syndromes and Nonalcoholic Fatty Liver Disease: “Un Affaire de Coeur” Canadian Journal of Gastroenterology and Hepatology |
| title | Acute Coronary Syndromes and Nonalcoholic Fatty Liver Disease: “Un Affaire de Coeur” |
| title_full | Acute Coronary Syndromes and Nonalcoholic Fatty Liver Disease: “Un Affaire de Coeur” |
| title_fullStr | Acute Coronary Syndromes and Nonalcoholic Fatty Liver Disease: “Un Affaire de Coeur” |
| title_full_unstemmed | Acute Coronary Syndromes and Nonalcoholic Fatty Liver Disease: “Un Affaire de Coeur” |
| title_short | Acute Coronary Syndromes and Nonalcoholic Fatty Liver Disease: “Un Affaire de Coeur” |
| title_sort | acute coronary syndromes and nonalcoholic fatty liver disease un affaire de coeur |
| url | http://dx.doi.org/10.1155/2020/8825615 |
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