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Progression to Cirrhosis Leads to Improvement in Atherogenic Milieu

Samarth Patel1,2, Mohammad B Siddiqui3, Anchalia Chandrakumaran4

  • 1Division of Gastroenterology and Hepatology, Hunter-Holmes McGuire Veterans Affairs Medical Center, Virginia Commonwealth University, Richmond, VA, 23249, USA. patelsamarth@gmail.com.

Digestive Diseases and Sciences
|March 20, 2020
PubMed

Insights

Patients with cirrhosis have a low risk of cardiovascular disease (CVD) events, possibly due to improved atherogenic risk markers. Coronary artery disease (CAD) presence strongly predicts CVD events in this population.

Area of Science:

  • Cardiology
  • Hepatology
  • Internal Medicine

Background:

  • Coronary artery disease (CAD) is prevalent in cirrhosis patients, but its impact on cardiovascular disease (CVD) risk is unclear.
  • Understanding CVD events in cirrhosis is crucial for managing liver transplant candidates.

Purpose of the Study:

  • To evaluate CVD events in patients with decompensated cirrhosis.
  • To assess the impact of cirrhosis on biomarkers of atherogenesis.

Main Methods:

  • Included 682 patients with decompensated cirrhosis undergoing liver transplantation evaluation.
  • Propensity matched NASH cirrhosis patients with non-cirrhosis NASH patients to compare atherogenic risk biomarkers.
  • Followed patients for CVD events, non-cardiac death, or liver transplantation.

Main Results:

  • A composite CVD outcome occurred in 3.4% of patients.
  • Presence of any CAD significantly increased CVD event risk (HR=6.8), independent of other factors.
  • Cirrhosis patients showed reduced VLDL, sdLDL-C, LDL-C, triglycerides, but increased anti-atherogenic HDL-2 and adiponectin.

Conclusions:

  • CVD event risk is low in cirrhosis patients.
  • Improved atherogenic risk markers may contribute to the reduced CVD risk.
  • CAD presence remains a significant predictor of CVD events in this cohort.
Abstract

Keywords:
AtherosclerosisCardiovascular diseaseCirrhosisLipoproteinNonalcoholic steatohepatitis

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