The Influence of Nonalcoholic Fatty Liver Disease on the Platelet Hemostasis and Endothelial Function State in Patients with Stable Coronary Heart Disease

Nonalcoholic fatty liver disease (NAFLD) is associated with atherosclerosis and endothelial dysfunction, which, in turn, are associated with the prothrombotic state. The purpose of the study was to evaluate the peculiarities of changes in the platelet hemostasis and endothelial function in patients with stable coronary heart disease (CHD), depending on the presence and course of NAFLD. Material and methods. We examined 300 patients with stable CHD II-III classes: 160 patients without NAFLD (Group I); 140 patients with NAFLD (Group II). The control group consisted of 20 practically healthy people. All patients underwent general-clinical examination, electrocardiography, echocardiography, coronary angiography, evaluation of thrombocyte hemostasis and determination of plasma sVCAM-1 level were conducted. Results. Shortened time to start aggregation was revealed in all examined patients with stable CHD. In Group IIB this parameter was lower by 42.2% vs. Group I and by 27.2% vs. Group IIA (p<0.05). The speed of aggregation gradually increased as NAFLD progressed. In the case of non-alcoholic steatohepatitis this indicator exceeded its value in the control group by 73.6%, and in Group I and Group IIA by 51.1% and 27.0% respectively (p<0.05). An increase of platelets levels was revealed in all examined patients. However, on the background of NAFLD, an increase in platelet levels was more significant. It was established that the endothelial dysfunction by the plasma sVCAM-1 levels deepens with NAFLD progression and increased hyperaggregation. Conclusion. The presence of high platelets aggregation activity and endothelial dysfunction in patients with stable CHD combined with NAFLD should be considered as a marker of chronic atherothrombogenicity and thrombinemia, which is a factor of high cardiovascular risk in this category of patients.