Document Type : Original Article

Authors

• Ahmad Amouzeshi ¹
• Fatemeh Safarbeiranvand ²
• Fatemeh Mousavi Emadi ³
• Mojtaba Ghobaei-Arani ^{4, 5}
• Maryam Ghanbari Garekani ⁶
• Naser Kachuian Javadi ⁷
• Mahyar Mohammadifar ⁸
• Somaye Jomefourjan ⁹
• Zahra Amouzeshi ¹⁰
• Seyyed Ebrahim Hosseini Zargaz ¹

¹ Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran

² Department of Nursing, Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran

³ Department of Internal Medicine, Gastroenterology and Hepatology Division, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran

⁴ School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

⁵ Student Research Community, Isfahan University of Medical Sciences, Isfahan, Iran

⁶ Cardiovascular Research Center, Rajaie Cardiovascular Institute, Tehran, Iran

⁷ Shahid Beheshti University of Medical Sciences, Tehran, Iran

⁸ Department of Radiology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran

⁹ Department of Clinical Psychology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran

¹⁰ Department of Nursing, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran

Abstract

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a progressive hepatic disorder characterized by simple steatosis that may advance to steatohepatitis and fibrosis. Individuals with NAFLD carry a substantially elevated risk for adverse cardiovascular events and metabolic dysfunction.
Method: This cross-sectional analytical study was conducted at the Department of Cardiovascular Surgery, Vali-e-Asr Hospital, Birjand University of Medical Sciences (Birjand, Iran) between 2016 and 2017. A total of 100 consecutive adult candidates scheduled for open-heart surgery with cardiopulmonary bypass were enrolled via consecutive census sampling. Preoperatively, hepatic steatosis was diagnosed and graded using transabdominal ultrasonography. Baseline and postoperative day 2 liver transaminases (AST, ALT), bilirubin, alkaline phosphatase (ALP), complete blood counts, and lipid panels were quantified. Postoperative complications (cerebrovascular accident, surgical site infection, hemorrhage, renal failure) and mortality were tracked up to 30 days. Continuous variables were evaluated using the independent Student’s -test or Mann–Whitney test, and categorical variables were compared using Pearson’s Chi-square or Fisher’s exact test. Independent predictors were evaluated via univariate and multivariable binary logistic regression. A two-tailed -value was defined as statistically significant.
Results: Among the 100 evaluated patients, 23 (23.0%) were diagnosed with NAFLD. An inverse relationship was identified between serum ALP concentrations and baseline patient profiles in both cohorts. Furthermore, circulating bilirubin exhibited an inverse correlation with NAFLD. Metabolic profiles revealed a direct correlation between serum triglyceride concentrations and NAFLD, whereas high-density lipoprotein (HDL) levels correlated inversely. No statistically significant increase in 30-day major adverse surgical outcomes (stroke, surgical wound infection, or mortality) was observed in NAFLD patients ().
Conclusion: Cardiac surgery candidates presenting with NAFLD demonstrated elevated hemoglobin levels and reduced baseline bilirubin alongside characteristic atherogenic dyslipidemia. Although these biochemical trends highlight metabolic and hematologic alterations, they represent non-causal associations. Routine preoperative hepatic ultrasound and metabolic stratification remain prudent in open-heart surgery candidates.
 

Highlights

Ahmad Amouzeshi (PubMed) (Google Scholar)

Fatemeh Safarbeiranvand (PubMed) (Google Scholar)

Seyedeh Fatemeh Mousaviemadi (PubMed) (Google Scholar)

Mojtaba Ghobaei-Arani (PubMed) (Google Scholar)

Maryam Ghanbari Garekani (PubMed) (Google Scholar)

Naser Kachoueian (PubMed) (Google Scholar)

Mahyar Mohammadifar (PubMed) (Google Scholar)

Somaye Jomefourjan (PubMed) (Google Scholar)

Zahra Amouzeshi (PubMed) (Google Scholar) 

Seyyed Ebrahim Hosseini Zargaz (PubMed) (Google Scholar)

 

 

 

Keywords

• Non-alcoholic Fatty Liver Disease
• Coronary Artery Bypass
• Bilirubin
• Alkaline Phosphatase
• Cardiac Surgical Procedures

Main Subjects

• Cardiology