Samarth Patel1,2, Mohammad B Siddiqui3, Anchalia Chandrakumaran4, Viviana A Rodriguez5, Masoud Faridnia4, Jose Hernandez Roman4, Emily Zhang6, Michael V Patrone4, Genta Kakiyama7,3, Caroline Walker3, Adam Sima5, Robert J Minniti3, Sherry Boyett3, Jasmohan S Bajaj7,3, Arun Sanyal7,3, William M Pandak7,3, Chandra Bhati8, Mohammad Shadab Siddiqui7,3. 1. Division of Gastroenterology and Hepatology, Hunter-Holmes McGuire Veterans Affairs Medical Center, Virginia Commonwealth University, Richmond, VA, 23249, USA. patelsamarth@gmail.com. 2. Division of Gastroenterology and Hepatology, Virginia Commonwealth University, Richmond, USA. patelsamarth@gmail.com. 3. Division of Gastroenterology and Hepatology, Virginia Commonwealth University, Richmond, USA. 4. Department of Internal Medicine, Virginia Commonwealth University, Richmond, USA. 5. Department of Biostatistics, Virginia Commonwealth University, Richmond, USA. 6. School of Medicine, Virginia Commonwealth University, Richmond, USA. 7. Division of Gastroenterology and Hepatology, Hunter-Holmes McGuire Veterans Affairs Medical Center, Virginia Commonwealth University, Richmond, VA, 23249, USA. 8. Division of Transplant Surgery, Virginia Commonwealth University, Richmond, USA.
Abstract
INTRODUCTION: The prevalence of coronary artery disease (CAD) is high among patients with cirrhosis; however, the impact of it on cardiovascular disease (CVD) is not known. The aim of the current study was to evaluate CVD events in patients with cirrhosis and impact of cirrhosis on biomarkers of atherogenesis. METHODS: The study included 682 patients with decompensated cirrhosis referred for liver transplantation (LT) evaluation between 2010 and 2017. All patients were followed until they experienced a CVD event, non-cardiac death, liver transplantation or last follow-up. To evaluate mechanistic link, patients with NASH cirrhosis were propensity matched 1:2 to non-cirrhosis NASH patients and biomarkers of atherogenic risk were compared. RESULTS: The composite CVD outcome occurred in 23(3.4%) patients after a median follow-up period of 585 days (IQR 139, 747). A strong association between presence of any CAD and CVD event was noted (HR = 6.8, 95% CI 2.9, 15.9) that was independent of age, gender, BMI, and MELD score. In competing risk model, the combined rate of LT and non-cardiac was significantly higher when compared to the rate of CVD events. Marker of insulin resistance and inflammation-related markers were similar in patients with and without cirrhosis. Patients with cirrhosis were more likely to have reduced VLDL, sdLDL-C, LDL-C, and triglycerides. Interestingly, patients with cirrhosis had an increase in serum HDL-2, the anti-atherogenic lipoprotein, and adiponectin, a protective serum adipokine. CONCLUSION: The risk of CVD events in patients with cirrhosis is low and may potentially be due to improvement in markers of atherogenic risk.
INTRODUCTION: The prevalence of coronary artery disease (CAD) is high among patients with cirrhosis; however, the impact of it on cardiovascular disease (CVD) is not known. The aim of the current study was to evaluate CVD events in patients with cirrhosis and impact of cirrhosis on biomarkers of atherogenesis. METHODS: The study included 682 patients with decompensated cirrhosis referred for liver transplantation (LT) evaluation between 2010 and 2017. All patients were followed until they experienced a CVD event, non-cardiac death, liver transplantation or last follow-up. To evaluate mechanistic link, patients with NASH cirrhosis were propensity matched 1:2 to non-cirrhosis NASH patients and biomarkers of atherogenic risk were compared. RESULTS: The composite CVD outcome occurred in 23(3.4%) patients after a median follow-up period of 585 days (IQR 139, 747). A strong association between presence of any CAD and CVD event was noted (HR = 6.8, 95% CI 2.9, 15.9) that was independent of age, gender, BMI, and MELD score. In competing risk model, the combined rate of LT and non-cardiac was significantly higher when compared to the rate of CVD events. Marker of insulin resistance and inflammation-related markers were similar in patients with and without cirrhosis. Patients with cirrhosis were more likely to have reduced VLDL, sdLDL-C, LDL-C, and triglycerides. Interestingly, patients with cirrhosis had an increase in serum HDL-2, the anti-atherogenic lipoprotein, and adiponectin, a protective serum adipokine. CONCLUSION: The risk of CVD events in patients with cirrhosis is low and may potentially be due to improvement in markers of atherogenic risk.
Authors: J H Henriksen; S Fuglsang; F Bendtsen; E Christensen; S Møller Journal: Am J Physiol Gastrointest Liver Physiol Date: 2001-04 Impact factor: 4.052
Authors: Kristina Skålén; Maria Gustafsson; Ellen Knutsen Rydberg; Lillemor Mattsson Hultén; Olov Wiklund; Thomas L Innerarity; Jan Borén Journal: Nature Date: 2002-06-13 Impact factor: 49.962
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