Nonalcoholic fatty liver in nondiabetic patients with acute coronary syndromes

Maria Boddi, Roberto Tarquini, Marco Chiostri, Fabio Marra, Serafina Valente, Cristina Giglioli, Gian F. Gensini, Rosanna Abbate

Research output: Contribution to journalArticlepeer-review


Background: Growing evidence was collected that non-alcoholic liver fatty disease (NAFLD) is a risk factor for coronary atherosclerosis in terms of angiographic appearance, but its involvement in acute coronary syndromes is still debated. We investigated the prevalence and severity of NAFLD in non-diabetic patients admitted for ST-segment elevation myocardial infarction (STEMI) and its association with multi-vessel coronary artery disease (CAD). Materials and methods: Ninety-five consecutive non-diabetic patients admitted to cardiac ICU for STEMI were studied by ultrasound within 72 h from admission. NAFLD was graded according to a semi-quantitative severity score as mild (score <3) or moderate-severe (> 3 score). Prevalence of cardiovascular (CV) risk factors, atherosclerotic burden markers and metabolic syndrome (MS) was investigated. Results: The overall prevalence of NAFLD was 87%. Forty-eight patients showed moderate-severe NAFLD (SFLD). Thirty-five patients showed mild NAFLD (MLFD group) and 12 patients had no NAFLD. Patients with SFLD were younger and showed higher prevalence of multi-vessel CAD (i.e. > 2) than patients with mild MFLD (P <0·01). Total cholesterol, triglycerides, body mass index and waist circumference were higher and HDL lower in SFLD than MFLD patients. About 50% of all NAFLD patients did not have MS. MS prevalence was higher in SFLD than MLFD patients (P <0·05) and among MS components, waist circumference and triglyceride levels showed the strongest association with SFLD (P <0·05). At logistic regression analysis, SFLD was independently associated with a three-fold risk of multi-vessel CAD. Conclusions: In non-diabetic patients admitted for STEMI NAFLD prevalence was very high. Severe NAFLD independently increased the risk for multi-vessel CAD associated to CV events.

Original languageEnglish
Pages (from-to)429-438
Number of pages10
JournalEuropean Journal of Clinical Investigation
Issue number5
Publication statusPublished - May 2013


  • Acute coronary syndromes
  • Metabolic syndrome
  • Non alcoholic fatty liver disease
  • Ultrasound

ASJC Scopus subject areas

  • Medicine(all)
  • Clinical Biochemistry
  • Biochemistry


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