Non-Alcoholic Fatty Liver Disease Clinical Trial
Official title:
Prevalence and Impact of NAFLD in Patients With Symptomatic Coronary Artery Disease
Although the clinical relationship between NAFLD/NASH and cardiovascular (CV) risk is now well established, there is very little awareness of the hepatic disease and the way it may contribute to increased CV risk in patients seen in cardiology clinics for complications of coronary artery disease. Our clinical hypothesis is that NAFLD, possibly at a stage of advanced fibrosis, is common in patients with symptomatic coronary artery disease (CAD) and increases the risk of severe atherosclerotic lesions. The primary aim of this study is to determine (a) the prevalence and (b) the severity spectrum of NAFLD among patients with symptomatic coronary artery disease. The secondary aims are: to analyze the impact of the presence and the severity spectrum of NAFLD (steatosis, steatohepatitis and fibrosis) on the severity of CAD ; To determine the profile of NAFLD patients at risk to develop coronary lesions; To explore the mechanistic link between NAFLD and CAD beyond common metabolic risk factors.
Because of shared metabolic risk factors and pathogenic pathways (insulin resistance, chronic
low grade inflammation, atherogenic dyslipidemia) non-alcoholic fatty liver disease is
frequently associated with cardiovascular (CV) disease. Despite a lot of transversal studies
showing a frequent association between NAFLD and CV disease, it is difficult to determine if
NAFLD plays an active role in atherogenesis or is just a marker of common risk factors. Some
longitudinal studies, although retrospectives, showed that NAFLD favors the progression of
early atherosclerosis, suggesting that NAFLD is an independent CV risk factor beyond the
association driven by metabolic syndrome.
Although the clinical relationship between NAFLD/NASH and CV risk is now well established,
there is very little awareness of the hepatic disease and the way it may contribute to
increased CV risk in patients seen in cardiology clinics for complications of coronary artery
disease (CAD). Our clinical hypothesis is that NAFLD, possibly at a stage of advanced
fibrosis, is common in patients with symptomatic CAD and increases the risk of severe
atherosclerotic lesions.
The primary aim of this study is to determine (a) the prevalence of NAFLD among patients with
symptomatic CAD.
The secondary aims are:
- To determine the severity spectrum of NAFLD among patients with coronary artery disease.
- To analyze the impact of the presence and the severity spectrum of NAFLD (steatosis,
steatohepatitis and fibrosis) on the severity of CAD and long term clinical outcomes
(ancillary studies)
- To determine the profile of NAFLD patients at risk to develop coronary lesions
- To explore the mechanistic link between NAFLD and CAD beyond common metabolic risk
factors.
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