Association of severity of coronary and carotid atherosclerosis and functional condition of a liver at patients with stable stenocardia and obesity

Abstract

The aim. To assess the relationships between the degree of severity of coronary and carotid atherosclerosis and the functional liver condition in patients with stable angina pectoris and obesity. Research materials and methods. During the study, two groups of patients were formed. Group I was composed of patients with stable angina and obesity (n = 69), group II - patients with stable angina with a normal body mass index (BMI) (n = 35). Measures of liver function, carbohydrate and lipid metabolism, results of duplex scanning of extracranial brachiocephalic arteries (BCA DS), coronaroangiography (CAG) data were evaluated, and biomarker of hepatic steatosis (НSI) were calculated. The severity of coronary atherosclerosis was analyzed by Gensini score (GS). All patients underwent ultrasound of the liver (ultrasound). Results. In 100% of patients of group I, non-alcoholic hepatic steatosis was detected according to ultrasound. Biomarker of hepatic steatosis (HSI) proved to be more significant among group I patients, while confirming the presence of steatosis. In patients of group I, more significant hypertriglyceridemia was established. Atherosclerotic plaques (according to the BCA DS) were detected in 100% patients of group I and in 68,5% patients of group II. Pronounced stenosis of СCA (≥75% of vessel lumen) is established in 14,5% patients of group I, and is not found among patients of group II. The proportion of patients with significant СA stenosis (> 70% vessel lumen) turned out to be greater in the I group, making up 69,5%, in the II group - 42,8% (χ2=6,9; р=0,009). The GS index values were more significant in patients of group I compared to group II (p = 0.01). Close correlation relationships have been identified between functional liver condition and the severity of coronary and carotid atherosclerosis. Biomarker of steatosis (HSI) have demonstrated their relationship with atherosclerotic lesions of ССA and CA. Conclusion. Against the background of impaired the functional liver condition in patients with stable stenocardia and obesity, more significant expression of coronary and carotid atherosclerosis is determined in comparison with patients with normal body mass index.