Effect of non-alcoholic fatty liver disease on outcome of primary pci in non-diabetic stemi patients

Document Type : Original Article

Authors

1 Cardiology Department, Faculty of Medicine, Assiut University, Assiut, Egypt

2 Internal medicine department, Faculty of Medicine, Assiut University, Assiut, Egypt

Abstract

Introduction: The effect of Non-alcoholic fatty liver disease (NAFLD) on outcome of patients with ST- segment elevation myocardial infarction (STEMI) is controversial. The purpose of the study aimed to assess the effect of non-alcoholic fatty liver disease (NAFLD) on myocardial and epicardial reperfusion after primary percutaneous coronary intervention (PPCI) to non-diabetic patients.
Methods: 240 non-diabetic patients with STEMI were recruited and underwent PPCI. After revascularization, epicardial reperfusion had been assessed by Thrombolysis in myocardial infarction (TIMI) flow grades (TFG) and TIMI frame count (TFC), and myocardial reperfusion had been assessed by TIMI myocardial perfusion grade (TMP) and ST-segment resolution (STR). NAFLD had been assessed and graded based on abdominal ultrasonography then the patients were subdivided into; NAFLD group (111 patients) and non-NAFLD group (129 patients).
Results: The overall prevalence of NAFLD in the current study was 46.5%. Clinically, KILLIP class > I was significant in NAFLD group (24 (P< 0.001). Multi-vessel coronary artery disease (CAD) was significant in NAFLD group (63 (56.8%) vs. 23 (17.8%); P< 0.001). Eleven patients of NAFLD group died with no deaths occurred in the other group. Post-procedural myocardial blush grade (MBG) zero and 1 were significant in patients with NAFLD group (P< 0.001). Also, absent STR and TFC were significant (P< 0.001) in NAFLD group. Finally, NAFLD was an independent predictor for in-hospital and follow up cardiac events.
Conclusions: NAFLD is considered an independent risk factor for the occurrence of in-hospital and follow up adverse cardiac events after PPCI in non-diabetic patients. 

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