Non-invasive Liver Screening for Risk Assessment for Coronary Heart Disease

University of Leipzig216 enrolled

Overview

Background: Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome, which is one of the major risk factors of coronary heart disease (CHD). CHD is the most important manifestation of atherosclerosis, because of its immense morbidity and mortality. Transient elastography (TE, Fibroscan®) including the currently developed controlled attenuation parameter (CAP) is a non-invasive method for evaluation of liver fibrosis and steatosis, which is already implemented in routine care of patients with NAFLD. Hypothesis: The use of TE with CAP as screening for NAFLD might be an easy tool for risk assessment for CHD. Methods: Patients scheduled for routine coronary angiography will be screened for manifestation of NAFLD by TE including CAP, conventional ultrasound, clinical and laboratory parameters. Patients will be stratified for the presence of CHD based on the angiography results and correlation analysis with liver fat content will be performed. NFALD screening will be validated in a subgroup by MR-based measurements.

Study Type

OBSERVATIONAL

Enrollment

216

Conditions

Coronary Disease Non-alcoholic Fatty Liver Disease Elasticity Imaging Techniques

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * informed consent * age ≥ 18 years * patients with indication for routine coronary angiography Exclusion Criteria: * transplanted liver * resection of right liver lobe * transaminases of \> 5-fold upper limit * pregnancy or lactation * choleastasis on ultrasound imaging * active malignant or consuming disease 12 month before inclusion * congestive heart failure (EF\<30%, NYHA III or IV, diastolic dysfunction °III or IV * pulmonary hypertension (WHO °III or IV) Exclusion criteria for MR diagnostics * pacemaker or ICD * non removable magnetizable metal implants * claustrophobia

Outcomes

Primary Outcomes

Correlation of presence CHD and NAFLD

Routine angiography defines the presents of CHD. Fibroscan will determine whether and to which extent a NAFLD is present.

Time frame: 1 year

Secondary Outcomes

Correlation of severity of CHD and NAFLD

Correlation of severity of CHD defined by angiography (Multi or Single vessel disease) will be correlated by quantification of liver fibrosis and steatosis on Fibroscan.

Time frame: 1 year

Fibrocan vs MR-based methods

MRS will be evaluated and correlated to the results of Fibroscan in a subset of patients.

Time frame: 1 year

Correlation of NAFLD and intima media thickness

intima media thickness of the common carotid artery is correlated to the Fibroscan results

Time frame: 1 year

Correlation of NAFLD and other signs of atherosclerosis

Plaque burden of abdominal aorta and carotid artery will be correlated to the results of Fibroscan.

Time frame: 1 year

Non-invasive Liver Screening for Risk Assessment for Coronary Heart Disease

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes