Incremental predictive value of liver fat fraction based on spectral detector CT for major adverse cardiovascular events in T2DM patients with suspected coronary artery disease
Authors' conclusion
The elevated LFF emerged as an independent prognostic factor for MACE in patients with T2DM. Incorporating LFF with FRS and CACS provided incremental predictive power for MACE in patients with T2DM.
Study context
- Population
- Patients with T2DM presenting with chest distress and pain suggestive of coronary artery disease (CAD), August 2021–August 2022; Coronary computed tomography angiography (CCTA) and upper abdominal spectral detector computed tomography (SDCT) within 7 days; 41% male51 major adverse cardiovascular events (MACE)
- Participants
- 265 patients
- Exposure
- Liver fat fraction (LFF) tertiles; model with LFF, coronary artery calcium score (CACS) and framingham risk score (FRS) vs FRS model
- Outcome
- MACE: cardiac death, acute coronary syndrome (ACS), late-phase coronary revascularization, hospital admission for HF
- Follow-up
- Median 30 months
Main finding
As reported in the abstract
MACE
Hazard ratio (95% CI)P value
Second tertilevs Lowest tertile
3.161(1.163–8.593)
P = 0.024Third tertilevs Lowest tertile
4.372(1.591–12.014)
P = 0.004- LFF higher in patients with MACE than without
- P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| Predictive performance: LFF + CACS + FRS model vs FRS modelLFF + CACS + FRS model vs FRS model | NRI 0.397 (95% CI 0.187–0.528) | P < 0.01 |
| Predictive performance: LFF + CACS + FRS model vs FRS modelLFF + CACS + FRS model vs FRS model | IDI 0.100 (95% CI 0.043–0.190) | P < 0.01 |
- Predictive performance: LFF + CACS + FRS model vs FRS model — C-index of LFF + CACS + FRS model
- 0.725
Predictive performance: LFF + CACS + FRS model vs FRS model
- Stable clinical net benefit
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Incremental predictive value of liver fat fraction based on spectral detector CT for major adverse cardiovascular events in T2DM patients with suspected coronary artery disease. Cardiovasc Diabetol. Published 2 April 2025. doi:10.
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