BACKGROUND: Population studies report increased cardiovascular mortality in patients with cirrhosis. Coronary artery disease may be a trait of end-stage liver disease, but whether it is frequent or extensive in cirrhosis in general is unknown. Thus, we aimed to assess the prevalence and extent of coronary artery disease in unselected cirrhosis patients. MATERIALS AND METHODS: Using coronary computed tomography angiography, we investigated 52 patients from all Child-Pugh classes and aetiologies of cirrhosis without known cardiac disease for presence and severity of coronary artery disease in a cross-sectional design. Persons referred with new-onset chest pain served as controls. RESULTS: The prevalence of coronary artery disease was not significantly different between cirrhosis patients and controls (77% vs. 65%, P=0·19). However, cirrhosis patients had a markedly higher coronary artery calcification (Agatston) score than controls (120 [interquartile range, 0-345] vs. 5 [interquartile range, 0-86] HU, P=0·001). Likewise, patients with cirrhosis had a higher prevalence of extensive (≥5 coronary segments involved; 45% vs. 18%, P=0·01) and multivessel coronary disease (≥2 vessels involved; 75% vs. 53%, P=0·02). Furthermore, the total plaque volume whether noncalcified or calcified was higher in cirrhosis (117 [interquartile range, 0-310] vs. 36 [interquartile range, 0-148] mm3 , P=0·02). CONCLUSION: Coronary artery disease is equally prevalent in patients with cirrhosis and subjects with new-onset chest pain, but cirrhosis patients have more extensive and severe disease including several coronary high-risk features associated with myocardial ischaemia and a poor clinical outcome. The potential of preventive measures for coronary artery disease in cirrhosis needs attention.
BACKGROUND: Population studies report increased cardiovascular mortality in patients with cirrhosis. Coronary artery disease may be a trait of end-stage liver disease, but whether it is frequent or extensive in cirrhosis in general is unknown. Thus, we aimed to assess the prevalence and extent of coronary artery disease in unselected cirrhosispatients. MATERIALS AND METHODS: Using coronary computed tomography angiography, we investigated 52 patients from all Child-Pugh classes and aetiologies of cirrhosis without known cardiac disease for presence and severity of coronary artery disease in a cross-sectional design. Persons referred with new-onset chest pain served as controls. RESULTS: The prevalence of coronary artery disease was not significantly different between cirrhosispatients and controls (77% vs. 65%, P=0·19). However, cirrhosispatients had a markedly higher coronary artery calcification (Agatston) score than controls (120 [interquartile range, 0-345] vs. 5 [interquartile range, 0-86] HU, P=0·001). Likewise, patients with cirrhosis had a higher prevalence of extensive (≥5 coronary segments involved; 45% vs. 18%, P=0·01) and multivessel coronary disease (≥2 vessels involved; 75% vs. 53%, P=0·02). Furthermore, the total plaque volume whether noncalcified or calcified was higher in cirrhosis (117 [interquartile range, 0-310] vs. 36 [interquartile range, 0-148] mm3 , P=0·02). CONCLUSION:Coronary artery disease is equally prevalent in patients with cirrhosis and subjects with new-onset chest pain, but cirrhosispatients have more extensive and severe disease including several coronary high-risk features associated with myocardial ischaemia and a poor clinical outcome. The potential of preventive measures for coronary artery disease in cirrhosis needs attention.
Authors: Samarth Patel; Mohammad B Siddiqui; Anchalia Chandrakumaran; Viviana A Rodriguez; Masoud Faridnia; Jose Hernandez Roman; Emily Zhang; Michael V Patrone; Genta Kakiyama; Caroline Walker; Adam Sima; Robert J Minniti; Sherry Boyett; Jasmohan S Bajaj; Arun Sanyal; William M Pandak; Chandra Bhati; Mohammad Shadab Siddiqui Journal: Dig Dis Sci Date: 2020-03-18 Impact factor: 3.199
Authors: Irina Gîrleanu; Anca Trifan; Laura Huiban; Cristina Muzîca; Oana Cristina Petrea; Ana Maria Sîngeap; Camelia Cojocariu; Stefan Chiriac; Tudor Cuciureanu; Irina Iuliana Costache; Carol Stanciu Journal: Life (Basel) Date: 2022-07-12
Authors: Peter Jepsen; Elliot B Tapper; Thomas Deleuran; Konstantin Kazankov; Gro Askgaard; Henrik Toft Sørensen; Hendrik Vilstrup; Joe West Journal: Hepatology Date: 2021-09-09 Impact factor: 17.425