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01.08.2014 | original article | Ausgabe 15-16/2014

Wiener klinische Wochenschrift 15-16/2014

Nonalcoholic fatty liver disease (NAFLD) proven by transient elastography in patients with coronary heart disease

Wiener klinische Wochenschrift > Ausgabe 15-16/2014
MD Ivana Mikolasevic, Lidija Orlic, Sandra Milic, Vesna Lukenda, Sanjin Racki, Davor Stimac, Ervin Avdovic, Luka Zaputovic



The relationship between nonalcoholic fatty liver disease (NAFLD) and coronary heart disease (CHD) is poorly understood. In the present study, we aimed to assess the frequency of NAFLD in CHD patients by using a new diagnostic tool: transient elastography (TE; Fibroscan®-CAP). Clarification of the present study may help to provide a new noninvasive tool for the assessment of NAFLD in this specific population of patients and may be of clinical importance in planning preventive strategies in high-risk patients.

Patients and methods

A total of 75 patients with proven CHD were enrolled. Liver stiffness was used to assess liver fibrosis, and controlled attenuation parameter (CAP) was used to detect and quantify liver steatosis by using Fibroscan® (Echosens, Paris, France). By CAP being implemented on TE, both liver steatosis and fibrosis can be evaluated simultaneously.


Of the 75 patients, 45 (60 %) had CAP > 238 dBm−1 and, by definition, NAFLD. Among the patients with NAFLD, 24 (53.3 %) had, in addition, liver stiffness > 7 kPa. Analyzing the influence of the degree of liver steatosis (expressed by CAP values) on the degree of CHD (defined by single or multiple vessels involved), we found that patients with multiple vessels involved had higher CAP values (p = 0.002). Furthermore, we noticed that significantly more patients with multiple vessels involved had liver stiffness > 7 kPa (p < 0.0001) indicating the more severe form of NAFLD in those patients.


The main finding of our study is that TE provides the opportunity of noninvasive screening for NAFLD in CHD patients, as it is a quick, simple, reliable, and repeatable method and more cost-effective than liver biopsy.

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