"As it is known that atherosclerosis is linked to inflammation, our next step was to look for an association of high-risk plaques with other systemic inflammatory conditions such as NAFLD," said the study's lead author, Stefan B. Puchner, M.D., from Massachusetts General Hospital and Harvard Medical School in Boston and the Medical University of Vienna, Austria. "Interestingly, both pathologies can be detected in a single CT examination."

The researchers drew patients from a large trial focusing on the use of CCTA in people who had come to the emergency department with acute chest pain. The patients underwent both non-enhanced CT to assess coronary calcium, a marker of atherosclerosis, and contrast-enhanced CCTA. Readers assessed the CCTA images for signs of high-risk plaque.

Overall, 182 of the 445 patients in the study, or 40.9 percent, had CT evidence of NAFLD. High-risk plaque was seen in 59.3 percent of patients with NAFLD, compared to only 19 percent of those without NAFLD. The association between NAFLD and high-risk plaque persisted after adjusting for the extent and severity of coronary atherosclerosis and traditional risk factors.

The results suggest that high-risk plaque and NAFLD are both part of the same systemic disease process, the metabolic syndrome.