High burden of coronary atherosclerosis in patients with cirrhosis

Konstantin Kazankov, Kim Munk, Kristian Altern Ovrehus, Jesper Moller Jensen, Cecilie Brockner Siggaard, Henning Gronbaek, Bjarne Linde Norgaard, Hendrik Vilstrup

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

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] mm(3), 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.
OriginalsprogEngelsk
TidsskriftEuropean Journal of Clinical Investigation. Supplement
Vol/bind47
Udgave nummer8
Sider (fra-til)565-573
ISSN0014-2972
DOI
StatusUdgivet - 2017

Fingeraftryk

Coronary Artery Disease

Emneord

  • Atherosclerosis
  • coronary CT angiography
  • liver disease
  • plaque

Citer dette

Kazankov, K., Munk, K., Ovrehus, K. A., Jensen, J. M., Siggaard, C. B., Gronbaek, H., ... Vilstrup, H. (2017). High burden of coronary atherosclerosis in patients with cirrhosis. European Journal of Clinical Investigation. Supplement, 47(8), 565-573. https://doi.org/10.1111/eci.12777
Kazankov, Konstantin ; Munk, Kim ; Ovrehus, Kristian Altern ; Jensen, Jesper Moller ; Siggaard, Cecilie Brockner ; Gronbaek, Henning ; Norgaard, Bjarne Linde ; Vilstrup, Hendrik. / High burden of coronary atherosclerosis in patients with cirrhosis. I: European Journal of Clinical Investigation. Supplement. 2017 ; Bind 47, Nr. 8. s. 565-573.
@article{98c110d1d41b4615887be228ab343b03,
title = "High burden of coronary atherosclerosis in patients with cirrhosis",
abstract = "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] mm(3), 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.",
keywords = "Atherosclerosis, coronary CT angiography, liver disease, plaque",
author = "Konstantin Kazankov and Kim Munk and Ovrehus, {Kristian Altern} and Jensen, {Jesper Moller} and Siggaard, {Cecilie Brockner} and Henning Gronbaek and Norgaard, {Bjarne Linde} and Hendrik Vilstrup",
year = "2017",
doi = "10.1111/eci.12777",
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volume = "47",
pages = "565--573",
journal = "European Journal of Clinical Investigation. Supplement",
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Kazankov, K, Munk, K, Ovrehus, KA, Jensen, JM, Siggaard, CB, Gronbaek, H, Norgaard, BL & Vilstrup, H 2017, 'High burden of coronary atherosclerosis in patients with cirrhosis', European Journal of Clinical Investigation. Supplement, bind 47, nr. 8, s. 565-573. https://doi.org/10.1111/eci.12777

High burden of coronary atherosclerosis in patients with cirrhosis. / Kazankov, Konstantin; Munk, Kim; Ovrehus, Kristian Altern; Jensen, Jesper Moller; Siggaard, Cecilie Brockner; Gronbaek, Henning; Norgaard, Bjarne Linde; Vilstrup, Hendrik.

I: European Journal of Clinical Investigation. Supplement, Bind 47, Nr. 8, 2017, s. 565-573.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - High burden of coronary atherosclerosis in patients with cirrhosis

AU - Kazankov, Konstantin

AU - Munk, Kim

AU - Ovrehus, Kristian Altern

AU - Jensen, Jesper Moller

AU - Siggaard, Cecilie Brockner

AU - Gronbaek, Henning

AU - Norgaard, Bjarne Linde

AU - Vilstrup, Hendrik

PY - 2017

Y1 - 2017

N2 - 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] mm(3), 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.

AB - 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] mm(3), 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.

KW - Atherosclerosis

KW - coronary CT angiography

KW - liver disease

KW - plaque

U2 - 10.1111/eci.12777

DO - 10.1111/eci.12777

M3 - Journal article

VL - 47

SP - 565

EP - 573

JO - European Journal of Clinical Investigation. Supplement

JF - European Journal of Clinical Investigation. Supplement

SN - 0960-135X

IS - 8

ER -