Prognostic value of non-alcoholic fatty liver disease in patients with pulmonary embolism

Nurcan Kaçmaz Kat; Nur Ozer Sensoy; Mustafa Kuzeytemiz; Ömer Furkan Demir

doi:10.18621/eurj.1353100

Araştırma Makalesi

Prognostic value of non-alcoholic fatty liver disease in patients with pulmonary embolism

Yıl 2024, Cilt: 10 Sayı: 1 - January 2024, 97 - 104, 04.01.2024

Nurcan Kaçmaz Kat Nur Ozer Sensoy Mustafa Kuzeytemiz Ömer Furkan Demir

https://doi.org/10.18621/eurj.1353100

Öz

Objectives: Pulmonary embolism (PE) is an important disease due to its mortality and morbidity-related clinical conditions. Patients with a high risk of death within 30 days are discriminated against with the help of various clinical scores. Non-alcoholic fatty liver disease (NAFLD) has been found to be associated with atherosclerosis. We aimed to investigate the effect of NAFLD on disease severity and early death rate in patients with pulmonary embolism.

Methods: This retrospective study includes patients who applied to the emergency department with suspected pulmonary embolism and whose diagnosis was confirmed according to the results of the examination. In addition to confirming the diagnosis of PE, hepatic steatosis was detected and graded by tomographic examination of the liver and spleen. Disease severity was stratified by Simplified Pulmonary Embolism Severity Index (sPESI).

Results: A total of 165 patients (105 with sPESI≥1 and 60 with sPESI<1 controls) were included. The rate of mortality was 12% (n=13) in the sPESI≥1 group. The prevalence of NAFLD was 64% and the prevalence of hepatosteatosis was similar according to disease severity and prognosis (67% vs. 58%; P=0.28 and 69% vs. 63%; P=0.77). Besides the effect of disease severity; chronic lung disease (CLD) and chronic kidney disease (CKD) were independently associated with poor prognosis by multivariate analysis [3.71 (1.02-13.46); P=0.04 and 15.89 (2.57-98.35); P=0.003].

Conclusion: No association between disease severity and prognosis was observed with NAFLD in acute PE disease.

Anahtar Kelimeler

Pulmonary embolism, simplified pulmonary embolism severity index, non-alcoholic fatty liver disease, hepatosteatosis

Kaynakça

1. Beckman MG, Hooper WC, Critchley SE, Ortel TL. Venous thromboembolism: a public health concern. Am J Prev Med. 2010;38(4 Suppl):S495-501. doi: 10.1016/j.amepre.2009.12.017.
2. Jiménez D, de Miguel-Díez J, Guijarro R, et al; RIETE Investigators. Trends in the management and outcomes of acute pulmonaryeEmbolism: analysis from the RIETE registry. J Am Coll Cardiol. 2016;67(2):162-170. doi: 10.1016/j.jacc.2015.10.060.
3. Jiménez D, Aujesky D, Moores L, et al, Yusen RD; RIETE Investigators. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med. 2010;170(15):1383-1389. doi: 10.1001/archinternmed.2010.199.
4. Heit JA. Venous thromboembolism: disease burden, outcomes and risk factors. J Thromb Haemost. 2005;3(8):1611-1617. doi: 10.1111/j.1538-7836.2005.01415.x.
5. Torres DM, Williams CD, Harrison SA. Features, diagnosis, and treatment of nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2012;10(8):837-58. doi: 10.1016/j.cgh.2012.03.011.
6. Zeina AR, Kopelman Y, Mari A, et al. Pulmonary embolism risk in hospitalized patients with nonalcoholic fatty liver disease: a case-control study. Medicine (Baltimore). 2022;101(45):e31710. doi: 10.1097/MD.0000000000031710.
7. Armstrong MJ, Adams LA, Canbay A, Syn WK. Extrahepatic complications of nonalcoholic fatty liver disease. Hepatology. 2014;59(3):1174-1197. doi: 10.1002/hep.26717.
8. Sookoian S, Pirola CJ. Non-alcoholic fatty liver disease is strongly associated with carotid atherosclerosis: a systematic review. J Hepatol. 2008;49(4):600-607. doi: 10.1016/j.jhep.2008.06.012.
9. Tripodi A, Fracanzani AL, Primignani M, et al. Procoagulant imbalance in patients with non-alcoholic fatty liver disease. J Hepatol. 2014 Jul;61(1):148-154. doi: 10.1016/j.jhep.2014.03.013.
10. Kotronen A, Joutsi-Korhonen L, Sevastianova K, et al. Increased coagulation factor VIII, IX, XI and XII activities in non-alcoholic fatty liver disease. Liver Int. 2011;31(2):176-183. doi: 10.1111/j.1478-3231.2010.02375.x.
11. Remy-Jardin M, Remy J, Wattinne L, Giraud F. Central pulmonary thromboembolism: diagnosis with spiral volumetric CT with the single-breath-hold technique--comparison with pulmonary angiography. Radiology. 1992;185(2):381-387.
12. Davidson LE, Kuk JL, Church TS, Ross R. Protocol for measurement of liver fat by computed tomography. J Appl Physiol (1985). 2006;100(3):864-8. doi: 10.1152/japplphysiol.00986.2005.
13. Lee SW, Park SH, Kim KW, et al. Unenhanced CT for assessment of macrovesicular hepatic steatosis in living liver donors: comparison of visual grading with liver attenuation index. Radiology. 2007;244(2):479-485. doi: 10.1148/radiol.2442061177.
14. Kodama Y, Ng CS, Wu TT, et al. Comparison of CT methods for determining the fat content of the liver. AJR Am J Roentgenol. 2007;188(5):1307-1312. doi: 10.2214/AJR.06.0992.
15. Park SH, Kim PN, Kim KW, et al. Macrovesicular hepatic steatosis in living liver donors: use of CT for quantitative and qualitative assessment. Radiology. 2006;239(1):105-112. doi: 10.1148/radiol.2391050361.
16. Lee SS, Park SH. Radiologic evaluation of nonalcoholic fatty liver disease. World J Gastroenterol. 2014;20(23):7392-7402. doi: 10.3748/wjg.v20.i23.7392.
17. Yamashita Y, Morimoto T, Amano H, et al. Validation of simplified PESI score for identification of low-risk patients with pulmonary embolism: From the COMMAND VTE Registry. Eur Heart J Acute Cardiovasc Care. 2020;9(4):262-270. doi: 10.1177/2048872618799993.
18. Doğan E, Bacaksızlar Sarı F. Is fat deposition of renal sinus a concomitant finding to fatty liver disease? The first study regarding the relationship between kidney and liver fat content with non-contrast computed tomography. Spartan Med Res J. 2022;7(1):32411. doi: 10.51894/001c.32411.
19. Yılmaz A, Yılmaz F, Beydilli İ, et al. Ultrasonographically detected hepatosteatosis independently predicts the presence and severity of coronary artery disease. Afr Health Sci. 2022;22(2):273-285. doi: 10.4314/ahs.v22i2.31.
20. Foschi FG, Bedogni G, Domenicali M, et al. Prevalence of and risk factors for fatty liver in the general population of Northern Italy: the Bagnacavallo Study. BMC Gastroenterol. 2018;18(1):177. doi: 10.1186/s12876-018-0906-8.
21. Abdel-Razik A, Mousa N, Shabana W, et al. De novo portal vein thrombosis in non-cirrhotic non-alcoholic fatty liver disease: a 9-year prospective cohort study. Front Med (Lausanne). 2021;8:650818. doi: 10.3389/fmed.2021.650818.
22. Di Minno MN, Tufano A, Rusolillo A, Di Minno G, Tarantino G. High prevalence of nonalcoholic fatty liver in patients with idiopathic venous thromboembolism. World J Gastroenterol. 2010;16(48):6119-6122. doi: 10.3748/wjg.v16.i48.6119.
23. Tripodi A, Anstee QM, Sogaard KK, Primignani M, Valla DC. Hypercoagulability in cirrhosis: causes and consequences. J Thromb Haemost. 2011;9(9):1713-1723. doi: 10.1111/j.1538-7836.2011.04429.x.
24. Stine JG, Niccum BA, Zimmet AN, et al. Increased risk of venous thromboembolism in hospitalized patients with cirrhosis due to non-alcoholic steatohepatitis. Clin Transl Gastroenterol. 2018;9(3):140. doi: 10.1038/s41424-018-0002-y.
25. Lüthi-Corridori G, Giezendanner S, Kueng C, et al. Risk factors for hospital outcomes in pulmonary embolism: A retrospective cohort study. Front Med (Lausanne). 2023;10:1120977. doi: 10.3389/fmed.2023.1120977.
26. Isath A, Shah R, Bandyopadhyay D, et al. Dispelling the saddle pulmonary embolism myth (from a comparison of saddle versus non-saddle pulmonary embolism). Am J Cardiol. 2023;201:341-348. doi: 10.1016/j.amjcard.2023.06.048.
27. Ģībietis V, Kigitoviča D, Vītola B, Strautmane S, Skride A. Glomerular filtration rate as a prognostic factor for long-term mortality after acute pulmonary embolism. Med Princ Pract. 2019;28(3):264-272. doi: 10.1159/000497436.
28. Rattazzi M, Villalta S, De Lucchi L, et al. Chronic kidney disease is associated with increased risk of venous thromboembolism recurrence. Thromb Res. 2017;160:32-37. doi: 10.1016/j.thromres.2017.10.011.
29. Cantu-Martinez O, Martinez Manzano JM, Tito S, et al. Clinical features and risk factors of adverse clinical outcomes in central pulmonary embolism using machine learning analysis. Respir Med. 2023;215:107295. doi: 10.1016/j.rmed.2023.107295.
30. Fabbian F, Gallerani M, Pala M, et al. In-hospital mortality for pulmonary embolism: relationship with chronic kidney disease and end-stage renal disease. The hospital admission and discharge database of the Emilia Romagna region of Italy. Intern Emerg Med. 2013;8(8):735-740. doi: 10.1007/s11739-012-0892-8.
31. Park SH. Pulmonary embolism is more prevalent than deep vein thrombosis in cases of chronic obstructive pulmonary disease and interstitial lung diseases. Springerplus. 2016;5(1):1777. doi: 10.1186/s40064-016-3475-8.
32. Zhang T, Xue PJ, Li YY, Peng M, Sun XF, Shi JH. [Clinical and prognostic analysis of acute pulmonary thromboembolism in the elderly]. Zhonghua Jie He He Hu Xi Za Zhi. 2022;45(6):539-545. doi: 10.3760/cma.j.cn112147-20211126-00839. [Article in Chinese]
33. Bi W, Liang S, He Z, et al. The prognostic value of the serum levels of brain natriuretic peptide, troponin I, and D-dimer, in addition to the neutrophil-to-lymphocyte ratio, for the disease evaluation of patients with acute pulmonary embolism. Int J Gen Med. 2021;14:303-308. doi: 10.2147/IJGM.S288975.
34. Jiménez D, Díaz G, Molina J, et al. Troponin I and risk stratification of patients with acute nonmassive pulmonary embolism. Eur Respir J. 2008;31(4):847-853. doi: 10.1183/09031936.00113307.

Yıl 2024, Cilt: 10 Sayı: 1 - January 2024, 97 - 104, 04.01.2024

Nurcan Kaçmaz Kat Nur Ozer Sensoy Mustafa Kuzeytemiz Ömer Furkan Demir

https://doi.org/10.18621/eurj.1353100

Öz

Kaynakça

1. Beckman MG, Hooper WC, Critchley SE, Ortel TL. Venous thromboembolism: a public health concern. Am J Prev Med. 2010;38(4 Suppl):S495-501. doi: 10.1016/j.amepre.2009.12.017.
2. Jiménez D, de Miguel-Díez J, Guijarro R, et al; RIETE Investigators. Trends in the management and outcomes of acute pulmonaryeEmbolism: analysis from the RIETE registry. J Am Coll Cardiol. 2016;67(2):162-170. doi: 10.1016/j.jacc.2015.10.060.
3. Jiménez D, Aujesky D, Moores L, et al, Yusen RD; RIETE Investigators. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med. 2010;170(15):1383-1389. doi: 10.1001/archinternmed.2010.199.
4. Heit JA. Venous thromboembolism: disease burden, outcomes and risk factors. J Thromb Haemost. 2005;3(8):1611-1617. doi: 10.1111/j.1538-7836.2005.01415.x.
5. Torres DM, Williams CD, Harrison SA. Features, diagnosis, and treatment of nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2012;10(8):837-58. doi: 10.1016/j.cgh.2012.03.011.
6. Zeina AR, Kopelman Y, Mari A, et al. Pulmonary embolism risk in hospitalized patients with nonalcoholic fatty liver disease: a case-control study. Medicine (Baltimore). 2022;101(45):e31710. doi: 10.1097/MD.0000000000031710.
7. Armstrong MJ, Adams LA, Canbay A, Syn WK. Extrahepatic complications of nonalcoholic fatty liver disease. Hepatology. 2014;59(3):1174-1197. doi: 10.1002/hep.26717.
8. Sookoian S, Pirola CJ. Non-alcoholic fatty liver disease is strongly associated with carotid atherosclerosis: a systematic review. J Hepatol. 2008;49(4):600-607. doi: 10.1016/j.jhep.2008.06.012.
9. Tripodi A, Fracanzani AL, Primignani M, et al. Procoagulant imbalance in patients with non-alcoholic fatty liver disease. J Hepatol. 2014 Jul;61(1):148-154. doi: 10.1016/j.jhep.2014.03.013.
10. Kotronen A, Joutsi-Korhonen L, Sevastianova K, et al. Increased coagulation factor VIII, IX, XI and XII activities in non-alcoholic fatty liver disease. Liver Int. 2011;31(2):176-183. doi: 10.1111/j.1478-3231.2010.02375.x.
11. Remy-Jardin M, Remy J, Wattinne L, Giraud F. Central pulmonary thromboembolism: diagnosis with spiral volumetric CT with the single-breath-hold technique--comparison with pulmonary angiography. Radiology. 1992;185(2):381-387.
12. Davidson LE, Kuk JL, Church TS, Ross R. Protocol for measurement of liver fat by computed tomography. J Appl Physiol (1985). 2006;100(3):864-8. doi: 10.1152/japplphysiol.00986.2005.
13. Lee SW, Park SH, Kim KW, et al. Unenhanced CT for assessment of macrovesicular hepatic steatosis in living liver donors: comparison of visual grading with liver attenuation index. Radiology. 2007;244(2):479-485. doi: 10.1148/radiol.2442061177.
14. Kodama Y, Ng CS, Wu TT, et al. Comparison of CT methods for determining the fat content of the liver. AJR Am J Roentgenol. 2007;188(5):1307-1312. doi: 10.2214/AJR.06.0992.
15. Park SH, Kim PN, Kim KW, et al. Macrovesicular hepatic steatosis in living liver donors: use of CT for quantitative and qualitative assessment. Radiology. 2006;239(1):105-112. doi: 10.1148/radiol.2391050361.
16. Lee SS, Park SH. Radiologic evaluation of nonalcoholic fatty liver disease. World J Gastroenterol. 2014;20(23):7392-7402. doi: 10.3748/wjg.v20.i23.7392.
17. Yamashita Y, Morimoto T, Amano H, et al. Validation of simplified PESI score for identification of low-risk patients with pulmonary embolism: From the COMMAND VTE Registry. Eur Heart J Acute Cardiovasc Care. 2020;9(4):262-270. doi: 10.1177/2048872618799993.
18. Doğan E, Bacaksızlar Sarı F. Is fat deposition of renal sinus a concomitant finding to fatty liver disease? The first study regarding the relationship between kidney and liver fat content with non-contrast computed tomography. Spartan Med Res J. 2022;7(1):32411. doi: 10.51894/001c.32411.
19. Yılmaz A, Yılmaz F, Beydilli İ, et al. Ultrasonographically detected hepatosteatosis independently predicts the presence and severity of coronary artery disease. Afr Health Sci. 2022;22(2):273-285. doi: 10.4314/ahs.v22i2.31.
20. Foschi FG, Bedogni G, Domenicali M, et al. Prevalence of and risk factors for fatty liver in the general population of Northern Italy: the Bagnacavallo Study. BMC Gastroenterol. 2018;18(1):177. doi: 10.1186/s12876-018-0906-8.
21. Abdel-Razik A, Mousa N, Shabana W, et al. De novo portal vein thrombosis in non-cirrhotic non-alcoholic fatty liver disease: a 9-year prospective cohort study. Front Med (Lausanne). 2021;8:650818. doi: 10.3389/fmed.2021.650818.
22. Di Minno MN, Tufano A, Rusolillo A, Di Minno G, Tarantino G. High prevalence of nonalcoholic fatty liver in patients with idiopathic venous thromboembolism. World J Gastroenterol. 2010;16(48):6119-6122. doi: 10.3748/wjg.v16.i48.6119.
23. Tripodi A, Anstee QM, Sogaard KK, Primignani M, Valla DC. Hypercoagulability in cirrhosis: causes and consequences. J Thromb Haemost. 2011;9(9):1713-1723. doi: 10.1111/j.1538-7836.2011.04429.x.
24. Stine JG, Niccum BA, Zimmet AN, et al. Increased risk of venous thromboembolism in hospitalized patients with cirrhosis due to non-alcoholic steatohepatitis. Clin Transl Gastroenterol. 2018;9(3):140. doi: 10.1038/s41424-018-0002-y.
25. Lüthi-Corridori G, Giezendanner S, Kueng C, et al. Risk factors for hospital outcomes in pulmonary embolism: A retrospective cohort study. Front Med (Lausanne). 2023;10:1120977. doi: 10.3389/fmed.2023.1120977.
26. Isath A, Shah R, Bandyopadhyay D, et al. Dispelling the saddle pulmonary embolism myth (from a comparison of saddle versus non-saddle pulmonary embolism). Am J Cardiol. 2023;201:341-348. doi: 10.1016/j.amjcard.2023.06.048.
27. Ģībietis V, Kigitoviča D, Vītola B, Strautmane S, Skride A. Glomerular filtration rate as a prognostic factor for long-term mortality after acute pulmonary embolism. Med Princ Pract. 2019;28(3):264-272. doi: 10.1159/000497436.
28. Rattazzi M, Villalta S, De Lucchi L, et al. Chronic kidney disease is associated with increased risk of venous thromboembolism recurrence. Thromb Res. 2017;160:32-37. doi: 10.1016/j.thromres.2017.10.011.
29. Cantu-Martinez O, Martinez Manzano JM, Tito S, et al. Clinical features and risk factors of adverse clinical outcomes in central pulmonary embolism using machine learning analysis. Respir Med. 2023;215:107295. doi: 10.1016/j.rmed.2023.107295.
30. Fabbian F, Gallerani M, Pala M, et al. In-hospital mortality for pulmonary embolism: relationship with chronic kidney disease and end-stage renal disease. The hospital admission and discharge database of the Emilia Romagna region of Italy. Intern Emerg Med. 2013;8(8):735-740. doi: 10.1007/s11739-012-0892-8.
31. Park SH. Pulmonary embolism is more prevalent than deep vein thrombosis in cases of chronic obstructive pulmonary disease and interstitial lung diseases. Springerplus. 2016;5(1):1777. doi: 10.1186/s40064-016-3475-8.
32. Zhang T, Xue PJ, Li YY, Peng M, Sun XF, Shi JH. [Clinical and prognostic analysis of acute pulmonary thromboembolism in the elderly]. Zhonghua Jie He He Hu Xi Za Zhi. 2022;45(6):539-545. doi: 10.3760/cma.j.cn112147-20211126-00839. [Article in Chinese]
33. Bi W, Liang S, He Z, et al. The prognostic value of the serum levels of brain natriuretic peptide, troponin I, and D-dimer, in addition to the neutrophil-to-lymphocyte ratio, for the disease evaluation of patients with acute pulmonary embolism. Int J Gen Med. 2021;14:303-308. doi: 10.2147/IJGM.S288975.
34. Jiménez D, Díaz G, Molina J, et al. Troponin I and risk stratification of patients with acute nonmassive pulmonary embolism. Eur Respir J. 2008;31(4):847-853. doi: 10.1183/09031936.00113307.

Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	İngilizce
Konular	Tanı Radyografisi
Bölüm	Original Article
Yazarlar	Nurcan Kaçmaz Kat 0000-0002-8205-1850 Nur Ozer Sensoy 0000-0001-8809-2250 Mustafa Kuzeytemiz 0000-0002-3316-2490 Ömer Furkan Demir 0000-0002-0230-8442
Erken Görünüm Tarihi	18 Aralık 2023
Yayımlanma Tarihi	4 Ocak 2024
Gönderilme Tarihi	31 Ağustos 2023
Kabul Tarihi	7 Ekim 2023
Yayımlandığı Sayı	Yıl 2024 Cilt: 10 Sayı: 1 - January 2024

Kaynak Göster

AMA	Kaçmaz Kat N, Sensoy NO, Kuzeytemiz M, Demir ÖF. Prognostic value of non-alcoholic fatty liver disease in patients with pulmonary embolism. Eur Res J. Ocak 2024;10(1):97-104. doi:10.18621/eurj.1353100

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