Relationship Between Nonalcoholic Fatty Liver Disease and Severity of Coronary Artery Disease in Patients Undergoing Coronary Angiography

Objective: Nonalcoholic fatty liver disease has been connected to coronary artery disease, which is the main cause of mortality. The connection between the degree of nonalcoholic fatty liver disease-induced liver fibrosis and the severity of coronary artery disease is unclear, and it was aimed to be evaluated. Methods: 200 nonalcoholic fatty liver disease patients over the age of 18 who underwent emergency or elective coronary angiography were included in this study. Both nonalcoholic fatty liver disease fibrosis and fibrosis-4 scores were calculated to determine liver fibrosis stages. Carotid intima-media thickness and SYNergy between Percutaneous Coronary Intervention (PCI) with TAXus and cardiac surgery score were calculated to determine the severity of coronary artery disease. Results: There was no difference in carotid intima-media thickness between the groups in the fatty liver stages, but when the patients were staged according to nonalcoholic fatty liver disease fibrosis and fibrosis-4 scores, the mean of carotid intima-media thickness increased as the risk of fibrosis increased. When patients were classified into 2 categories based on their median carotid intima-media thickness value, a significant difference was realized in terms of nonalcoholic fatty liver disease fibrosis and fibrosis-4 scores. There was no significant difference in SYNergy between PCI with TAXus and cardiac surgery score when the patients were evaluated according to the fatty liver stages, nonalcoholic fatty liver disease fibrosis and fibrosis-4 scores. Considering severe coronary artery disease (SYNergy between PCI with TAXus and cardiac surgery score > 0 or not) when patients were classified into 2 categories, nonalcoholic fatty liver disease fibrosis was found to be higher in the group with severe coronary artery disease, however, there was no difference in fibrosis-4 scores between the groups. Conclusion: This study suggests that the frequency and severity of coronary artery disease increase in the progression from simple fatty liver to the fibrotic liver. Our data, supporting the literature, reveal that nonalcoholic fatty liver disease fibrosis is more closely related to the prevalence and severity of coronary artery disease than the fibrosis-4 score.