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Coronary artery disease as a risk factor for metabolic dysfunction-associated steatotic liver disease and liver
Luis Vega1, Daniela Simian1, Abraham I Gajardo2
1Gastroenterology Section, Medicine Department, Hospital Clínico Universidad de Chile, Santiago, Chile.
Insights
Metabolic dysfunction-associated steatotic liver disease (MASLD) is common in patients with coronary heart disease (CHD). Significant CHD increases the likelihood of liver fibrosis, suggesting further investigation in these patients.
Area of Science:
- Cardiology
- Hepatology
- Metabolic Diseases
Background:
- Patients with metabolic dysfunction-associated steatotic liver disease (MASLD) face elevated cardiovascular risk.
- Non-alcoholic fatty liver disease (NAFLD) is frequently observed in individuals with coronary heart disease (CHD).
- The relationship between significant CHD and the prevalence of liver fibrosis remains unclear.
Purpose of the Study:
- To determine the frequency of MASLD and liver fibrosis in patients with CHD.
- To assess the association between coronary stenosis severity and MASLD and liver fibrosis.
Main Methods:
- An observational study involving 113 adult patients undergoing coronary angiography for suspected coronary artery disease.
- Significant CHD defined as >50% stenosis in at least one coronary artery.
- Liver stiffness measured via elastography (FibroScan®) to assess liver fibrosis (>6.5 Kpa).
Main Results:
- 72% of patients had significant CHD; 52% had MASLD.
- Liver fibrosis was present in 12% of patients, notably higher in the significant CHD group (p=0.007).
- Increased coronary artery stenosis correlated with a higher probability of liver fibrosis (OR 1.79, p=0.029).
Conclusions:
- MASLD is highly prevalent in patients with significant CHD, even without prior liver disease diagnosis.
- These findings indicate a need to screen for MASLD and liver fibrosis in CHD patients.
- Future research should explore confounding factors like type 2 diabetes mellitus.
Introduction And Objectives:
Patients with metabolic dysfunction-associated steatotic liver disease (MASLD) are at an increased cardiovascular risk. On the contrary, non-alcoholic fatty liver disease (NAFLD) is highly prevalent in patients with coronary heart disease (CHD). However, it is not known whether patients with significant CHD show a higher frequency of liver fibrosis. This study aimed to determine the frequency of MASLD and liver fibrosis in patients with CHD and to assess whether coronary stenosis is significantly associated with MASLD and fibrosis.
Patients And Methods:
This observational and analytical study included adult patients without any known liver disease who underwent coronary angiography for suspected coronary artery disease (Jul 2021-Jul 2022). The presence of significant CHD (> 50% stenosis of at least one coronary artery) was determined. Liver elastography (FibroScan®) was performed up to 6 months after the coronary angiographic study to determine liver fibrosis, a measurement of liver stiffness (> 6.5 Kpa). Fisher's test, Mann-Whitney U test, and logistic regression models were used (p < 0.05).
Results:
The study included 113 patients (76% men, average age: 63 years [standard deviation: 9.9]), of which 72% presented with significant CHD. The prevalence rate of MASLD was 52%. Liver fibrosis was present in 12% of the patients and all patients in the significant CHD group (p = 0.007). An increase in the number of vessels with significant CHD increased the probability of liver fibrosis (odds ratio, 1.79; 95% confidence interval, 1.06-3.04; p = 0.029).
Conclusions:
MASLD is highly prevalent in patients with significant CHD but without known liver damage. These data suggest that MASLD and liver fibrosis should be investigated in patients with CHD. The presence of confounding variables, especially the presence of type 2 diabetes mellitus, should be evaluated in further studies.
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