Nonalcoholic Fatty Liver Disease Linked to Worse Outcomes in STEMI

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NAFLD predicts impaired myocardial perfusion after PCI in STEMI.
NAFLD predicts impaired myocardial perfusion after PCI in STEMI.

(HealthDay News) — For patients without diabetes with ST-segment myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI), nonalcoholic fatty liver disease (NAFLD) independently predicts impaired myocardial perfusion and adverse in-hospital outcomes, according to a study published in The American Journal of Cardiology.

Ayse Emre, MD, from the Siyami Ersek Thoracic and Cardiovascular Surgery Center in Istanbul, and colleagues examined the impact of NAFLD on myocardial perfusion and in-hospital major adverse cardiac events (MACE) in the setting of STEMI. Data were included for 186 consecutive patients without diabetes who underwent primary PCI for STEMI. Patients were categorized according to NAFLD severity score: mild (<3) or moderate-to-severe (≥3).

The researchers found that the post-procedural Thrombosis in Myocardial Infarction (TIMI) 3 flow grade did not differ between the groups (89% vs 83%; P=.201). The likelihood of having absent myocardial perfusion (indicated by myocardial blush grade [MBG] 0 to 1), absent ST-segment resolution (STR), and higher in-hospital MACE rate was increased for patients with NAFLD scores ≥3. NAFLD ≥3 was an independent predictor for absent MBG 0/1, absent STR, and in-hospital MACE (odds ratios=2.856, 2.862, and 2.454, respectively).

"We found that despite similar high rates of TIMI 3 after primary PCI, patients with NAFLD score ≥3 are more likely to have impaired myocardial perfusion which may contribute to adverse in-hospital outcome," the researchers wrote.

Reference

  1. Emre A, Terzi S, Celiker E, et al. Impact of Nonalcoholic Fatty Liver Disease on Myocardial Perfusion in Nondiabetic Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction. Am J Cardiol. 2015;116(12):1810-1814.
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