Liver: An alarm for the heart?

Background/Aims: Fatty liver (FL) and coronary artery disease (CAD) have several risk factors in common, which are usually considered to account for their frequent coexistence. The independent association between FL and angiographic CAD was assessed in this case-control study by considering the contribution of their shared risk factors. Methods: Three hundred and seventeen adult patients who underwent elective coronary angiography (CAG) were recruited immediately after CAG and classified into either of the two groups A (normal or mildly abnormal CAG; n = 85) or B (clinically relevant CAD; n = 232). A liver sonography was performed on the same day as CAG. Results: The groups were significantly different in terms of gender, fasting blood glucose, low-density lipoproteins, diabetes (DM), hypertension and FL. In binary logistic regression, FL was the strongest independent predictor of CAD [P < 0.001, odds ratio (OR) = 8.48%, 95% confidence interval (CI) = 4.39-16.40], followed by DM (P = 0.002, OR = 2.94) and male gender (P = 0.014, OR = 2.31). This pattern of associations did not change after clinically significant variables (waist-to-hip ratio, body mass index, triglycerides and high-density lipoproteins) were added to analysis. Conclusion: Fatty liver seems to be a strong independent alarm for the presence of significant CAD.