High liver fat fraction in CCTA helps diagnose major adverse cardiovascular events in T2DM patients: Study

During a median follow-up of 30 months, 51 MACE cases were reported among 265 patients (41% male). The patients with type 2 diabetes who had MACE had a significantly greater LFF than those who did not. The cutoffs of 4.10 and 8.30 were used to separate the LFF into tertiles.

Kaplan-Meier analysis showed that regardless of the various subgroups in the coronary artery calcium score (CACS) or framingham risk score (FRS), individuals with greater LFF had a higher chance of developing MACE.

The findings of the multivariate Cox regression showed that patients with T2DM in the second and third tertiles had a considerably greater risk of MACE than those in the lowest tertile. The independent associations of LFF tertile and CACS with MACE persisted even after controlling for early revascularization.

Also, a net reclassification improvement (NRI) of 0.397, and an integrated discrimination improvement (IDI) of 0.100, the model incorporating LFF, CACS, and FRS outperformed the traditional FRS model in terms of predictive performance and stable clinical net benefit with a C-index of 0.725. Overall, LFF as measured by non-enhanced SDCT was found to be an independent predictor of MACE in T2DM patients, even when early revascularization was taken into account.

Source:

Wang, M., Wei, T., Sun, L., Zhen, Y., Bai, R., Lu, X., Ma, Y., & Hou, Y. (2025). 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. Cardiovascular Diabetology, 24(1), 151. https://doi.org/10.1186/s12933-025-02704-w