Hepatosteatosis and Atherosclerotic Plaque at Coronary CT Angiography

Jessica Carter; Thomas D Heseltine; Mohammed N Meah; Evangelos Tzolos; Jacek Kwiecinski; Mhairi Doris; Priscilla McElhinney; Alastair J Moss; Philip D Adamson; Amanda Hunter; Shirjel Alam; Anoop S V Shah; Tania Pawade; Chengjia Wang; Jonathan R Weir-McCall; Giles Roditi; Edwin J R van Beek; Edward D Nicol; Leslee J Shaw; Daniel S Berman; Piotr J Slomka; Nicholas L Mills; Marc R Dweck; David E Newby; Scott W Murray; Damini Dey; Michelle C Williams

doi:10.1148/ryct.210260

Hepatosteatosis and Atherosclerotic Plaque at Coronary CT Angiography

Radiol Cardiothorac Imaging. 2022 Apr 28;4(2):e210260. doi: 10.1148/ryct.210260. eCollection 2022 Apr.

Authors

Jessica Carter¹, Thomas D Heseltine¹, Mohammed N Meah¹, Evangelos Tzolos¹, Jacek Kwiecinski¹, Mhairi Doris¹, Priscilla McElhinney¹, Alastair J Moss¹, Philip D Adamson¹, Amanda Hunter¹, Shirjel Alam¹, Anoop S V Shah¹, Tania Pawade¹, Chengjia Wang¹, Jonathan R Weir-McCall¹, Giles Roditi¹, Edwin J R van Beek¹, Edward D Nicol¹, Leslee J Shaw¹, Daniel S Berman¹, Piotr J Slomka¹, Nicholas L Mills¹, Marc R Dweck¹, David E Newby¹, Scott W Murray¹, Damini Dey¹, Michelle C Williams¹

Affiliation

¹ University/BHF Centre for Cardiovascular Science, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh, Scotland EH16 SUF, (J.C., M.N.M., E.T., J.K., M.D., A.J.M., P.D.A., A.H., S.A., A.S.V.S., T.P., C.W., N.L.M., M.R.D., D.E.N., M.C.W.); Liverpool Centre for Cardiovascular Science, Liverpool, England (T.D.H., S.W.M.); Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland (J.K.); Biomedical Imaging Research Institute and Division of Artificial Intelligence in Medicine, Cedars-Sinai Medical Center, Los Angeles, Calif (P.M., D.S.B., P.J.S., D.D.); Christchurch Heart Institute, University of Otago, Christchurch, New Zealand (P.D.A.); Department of Radiology, University of Cambridge, Cambridge, England (J.R.W.M.); Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland (G.R.); Edinburgh Imaging Facility QMRI, University of Edinburgh, Edinburgh, Scotland (E.J.R.v.B., M.R.D., D.E.N., M.C.W.); Royal Brompton and Harefield NHS Foundation Trust Departments of Cardiology and Radiology, London, England and the National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, England (E.D.N.); and Icahn School of Medicine, Weill Cornell Medical College, New York, NY (L.J.S.).

Abstract

Purpose: To assess the association between nonalcoholic fatty liver disease (NAFLD) and quantitative atherosclerotic plaque at CT.

Materials and methods: In this post hoc analysis of the prospective Scottish Computed Tomography of the HEART trial (November 2010 to September 2014), hepatosteatosis and coronary artery calcium score were measured at noncontrast CT. Presence of stenoses, visually assessed high-risk plaque, and quantitative plaque burden were assessed at coronary CT angiography. Multivariable models were constructed to assess the impact of hepatosteatosis and cardiovascular risk factors on coronary artery disease.

Results: Images from 1726 participants (mean age, 58 years ± 9 [SD]; 974 men) were included. Participants with hepatosteatosis (155 of 1726, 9%) had a higher body mass index, more hypertension and diabetes mellitus, and higher cardiovascular risk scores (P < .001 for all) compared with those without hepatosteatosis. They had increased coronary artery calcium scores (median, 43 Agatston units [AU] [interquartile range, 0-273] vs 19 AU [0-225], P = .046), more nonobstructive disease (48% vs 37%, P = .02), and higher low-attenuation plaque burden (5.11% [0-7.16] vs 4.07% [0-6.84], P = .04). However, these associations were not independent of cardiovascular risk factors. Over a median of 4.7 years, there was no evidence of a difference in myocardial infarction between those with and without hepatosteatosis (1.9% vs 2.4%, P = .92).

Conclusion: Hepatosteatosis at CT was associated with an increased prevalence of coronary artery disease at CT, but this was not independent of the presence of cardiovascular risk factors.Keywords: CT, Cardiac, Nonalcoholic Fatty Liver Disease, Coronary Artery Disease, Hepatosteatosis, Plaque QuantificationClinical trial registration no. NCT01149590 Supplemental material is available for this article. © RSNA, 2022See also commentary by Abohashem and Blankstein in this issue.

Keywords: CT; Cardiac; Coronary Artery Disease; Hepatosteatosis; Nonalcoholic Fatty Liver Disease; Plaque Quantification.

Abstract

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