A new study published in the journal Radiology has uncovered a connection between high-risk coronary artery plaque and a non-alcoholic fatty liver disease (NAFLD), a liver condition found in 20 to 30% of the general population. Researchers found that use of coronary computed tomography angiography (CCTA) could detect both conditions.

“As it is known that atherosclerosis [hardening of the arteries] is linked to inflammation, our next step was to look for an association of high-risk plaques with other systemic inflammatory conditions such as NAFLD,” said the study’s lead author, Stefan B. Puchner, MD, from Massachusetts General Hospital and Harvard Medical School in Boston and the Medical University of Vienna, Austria. “Interestingly, both pathologies can be detected in a single CT examination.”

The study evaluated patients involved in a large trial focusing on the use of CCTA in people who had arrived at the emergency department with acute chest pain. The patients underwent both non-enhanced CT to assess coronary calcium, an indicator of atherosclerosis, and contrast-enhanced CCTA. Readers assessed the CCTA images for signs of high-risk plaque.

Overall, 182 of the 445 patients in the study, or 40.9%, had CT evidence of NAFLD. High-risk plaque was seen in 59.3% of patients with NAFLD, compared to only 19% of those without NAFLD. The association between NAFLD and high-risk plaque persisted after adjusting for the extent and severity of coronary atherosclerosis and traditional risk factors, suggesting that both conditions are caused by the same systemic disease process, the metabolic syndrome.

“The clinical implications could include a wider assessment of NAFLD using the non-contrast cardiac CT scans that are commonly performed prior to the CTA,” Puchner said. “Further, the additional assessment of NAFLD with CT could improve the risk stratification of patients with suspected coronary artery disease, as our results show that the presence of NAFLD is associated with high-risk coronary plaque independent of traditional risk factors and severity of coronary artery disease.”

Researchers plan to extend the study to determine if the link applies to the general population outside the emergency department and to learn about why NAFLD is so prevalent among people with advanced high-risk coronary atherosclerosis.

To read the article, visit Radiology.