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Coronary CT Angiography Reveals Link between Coronary Artery Plaque and Liver Disease

By MedImaging International staff writers
Posted on 19 Nov 2014

Image: Coronary CT angiography images demonstrate examples of high-risk plaque features. A, Image was obtained in a 63-year-old man with partially calcified plaque, positive remodeling (vertical arrow), and spotty calcium (horizontal arrow). B, A cross-sectional view of a noncalcified plaque in a 65-year-old man demonstrates a napkin-ring sign with a central low-attenuation area, surrounded by a peripheral rim of higher attenuation (arrow) next to the lumen (∗). C, Image in a 60-year-old woman with partially calcified plaque demonstrates a low CT number in the midportion (arrow) (Photo courtesy of the journal Radiology).

Image: Axial nonenhanced CT image in a 62-year-old man demonstrates attenuation measurements of the liver and spleen. Image shows a diffuse fat accumulation in the liver, with a mean liver attenuation of 32.5 HU and a mean spleen attenuation of 46.2 HU (Photo courtesy of the Radiological Society of North America, and the journal Radiology).

Researchers using coronary computed tomography angiography (CCTA) imaging have found a close correlation between high-risk coronary artery plaque and a common liver disease. The research revealed that a single CT scan can detect both conditions.

Earlier research has shown that CCTA can identify high-risk coronary artery plaque, or plaque prone to life-threatening ruptures. For the new study, researchers examined the association between high-risk plaque and non-alcoholic fatty liver disease (NAFLD), a disorder characterized by abnormal liver function that is not associated with excessive alcohol consumption. NAFLD is the most common liver disease, with an estimated prevalence of 20%–30% in the general population.

“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, MD, from Massachusetts General Hospital (MGH) and Harvard Medical School (both based in Boston, MA, USA) and the Medical University of Vienna (Austria). “Interestingly, both pathologies can be detected in a single CT examination.”

The researchers, who published their findings online November 4, 2014, in the journal Radiology, 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 nonenhanced CT to evaluate 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 (40.9%) had CT evidence of NAFLD. High-risk plaque was seen in 59.3% of patients with NAFLD, compared to only 19% 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. “The clinical implications could include a wider assessment of NAFLD using the non-contrast cardiac CT scans that are commonly performed prior to the CTA,” he said. “Further, the additional assessment of NAFLD with CT could improve the risk stratification of patients with suspected coronary artery disease, as our results show that the presence of NAFLD is associated with high-risk coronary plaque independent of traditional risk factors and severity of coronary artery disease.”

The researchers plan to extend the study outside of the emergency department setting to see if the results apply to other categories of the general population. They also hope to learn more about why NAFLD is so prevalent among people with advanced high-risk coronary atherosclerosis. One prevailing theory is that both conditions are a consequence of systemic inflammation, an inflammatory state that affects multiple organs and can lead to deadly disorders.

“The aim will be to further investigate and understand, with the help of CCTA, the interplay between advanced atherosclerosis and NAFLD as part of a complex systemic inflammatory condition,” Dr. Puchner concluded.

Related Links:
Massachusetts General Hospital
Medical University of Vienna

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60 (640.1538848877): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

61 (!!!!! 18311.023712158): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

62 (!!!!! 4433.8703155518): SELECT fid FROM jos_deeppockets WHERE id=294755775 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294755775 AND published='1' LIMIT 1

63 (!!!!! 2711.0576629639): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

64 (!!!!! 1888.0367279053): select jos_twitters.link from jos_twitters where cat=10

65 (540.01808166504): select jos_facebook.link from jos_facebook where cat=10

66 (339.03121948242): select jos_google_plus.link from jos_google_plus where cat=10

67 (39.100646972656): select jos_linkedin.link from jos_linkedin where cat=10

68 (359.77363586426): SELECT fid FROM jos_deeppockets WHERE id=294755775 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294755775 AND published='1' LIMIT 1

69 (39.815902709961): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

70 (871.89674377441): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294755775 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (533.10394287109): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294755775 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (114.91775512695): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (81.062316894531): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (667.81044006348): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (108.00361633301): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (634.90867614746): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (176.19132995605): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 2087.8314971924): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294755775 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (422.95455932617): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294755775 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (356.91261291504): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (407.93418884277): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (!!!!! 2756.8340301514): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (226.97448730469): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (283.95652770996): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (152.1110534668): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (799.89433288574): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (300.88424682617): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (158.07151794434): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (953.91273498535): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

105 (223.15979003906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

106 (272.03559875488): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294755775 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (913.14315795898): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294755775 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 7791.9960021973): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

109 (204.80155944824): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

110 (144.95849609375): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294755775 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (890.01655578613): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294755775 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (639.91546630859): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (460.86311340332): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (95.129013061523): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

115 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

116 (434.87548828125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

117 (59.127807617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

118 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

119 (230.07392883301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

120 (154.01840209961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

121 (339.98489379883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

122 (318.76564025879): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 41951.894760132): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (!!!!! 1255.989074707): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294755775 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294755775 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 17598.152160645): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (58.889389038086): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (535.01129150391): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (38.862228393555): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (519.0372467041): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (40.054321289062): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (429.86869812012): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (58.174133300781): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (!!!!! 1262.1879577637): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (44.107437133789): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (842.80967712402): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (394.82116699219): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (193.11904907227): SELECT name FROM jos_deeppockets WHERE id=211

138 (193.11904907227): SELECT name FROM jos_deeppockets WHERE id=211

139 (743.15071105957): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (849.96223449707): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (437.97492980957): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

142 (!!!!! 2125.0247955322): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

143 (!!!!! 26417.970657349): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 4173.0403900146): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294755775 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (82.969665527344): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294755775 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (411.9873046875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (54.121017456055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (69.141387939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

149 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

150 (!!!!! 5025.8636474609): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (391.00646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

152 (249.86267089844): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

153 (422.95455932617): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294755775 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294755775 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (54.121017456055): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

155 (37.908554077148): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

156 (!!!!! 1904.9644470215): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (200.03318786621): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

158 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294755775 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294755775 AND published='1' LIMIT 1

159 (425.81558227539): select jos_twitters.link from jos_twitters where cat=10

160 (36.001205444336): select jos_facebook.link from jos_facebook where cat=10

161 (30.040740966797): select jos_google_plus.link from jos_google_plus where cat=10

162 (30.040740966797): select jos_linkedin.link from jos_linkedin where cat=10

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