Serum biomarker may predict coronary artery disease in NAFLD
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High-sensitivity cardiac troponin may be used as a marker for predicting coronary artery disease risk in patients with nonalcoholic fatty liver disease, according to a study published in Clinical Gastroenterology and Hepatology.

Cardiovascular disease is the most common cause of death among NAFLD patients. This study assessed select cardiac biomarker associations for existing or future coronary artery disease (CAD) risk in NAFLD patients.

Patients with/without NAFLD undergoing elective cardiac angiography were prospectively enrolled. Severe CAD was defined as presence of at least one proximal artery >70% stenosis; risk of severe CAD as either existing severe CAD or ASCVD score ?20; NAFLD was defined as hepatic fat in the absence of other liver diseases. Cardiac biomarkers [high-sensitivity CRP (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin I (hs-cTnI)] were measured using Atellica Solution assays.

-- 619 patients were enrolled (63±10 years, 80% male, 31% type 2 diabetes, 65% NAFLD); 42% had severe CAD and 57% had risk of severe CAD. NAFLD prevalence was similar between patients with and without severe CAD (68% vs. 62%).

-- NAFLD patients with severe CAD (44%) or with risk of severe CAD (58%) had higher levels of hs-cTnI than NAFLD controls.

-- Presence of severe CAD or risk of severe CAD in all patients was associated with older age, male, aspects of metabolic syndrome, and elevated hs-cTnI: odds ratio and 1.8 (1.1-3.0), respectively; 2.3 (1.4-3.8) and 2.2 (1.2-4.2), respectively, in patients with NAFLD.

Conclusively, CAD is common in NAFLD patients. High hs-cTnI was associated with an increased risk of CAD. Pending validation, hs-cTnI maybe a useful marker for CAD risk prediction in NAFLD patients.