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The prognostic value of metabolic dysfunction-associated steatotic liver disease in acute myocardial infarction: A
Gwyneth Kong1, Grace Cao2, Jaycie Koh3
1Department of Medicine, National University Hospital, Singapore, Singapore.
Aim:
Patients with metabolic dysfunction-associated steatotic liver disease (MASLD) are at increased risk of incident cardiovascular disease. However, the clinical characteristics and prognostic importance of MASLD in patients presenting with acute myocardial infarction (AMI) have yet to be examined.
Methods:
This study compared the characteristics and outcomes of patients with and without MASLD presenting with AMI at a tertiary centre in Singapore. MASLD was defined as hepatic steatosis, with at least one of five metabolic criteria. Hepatic steatosis was determined using the Hepatic Steatosis Index. Propensity score matching was performed to adjust for age and sex. The Kaplan-Meier curve was constructed for long-term all-cause mortality. Cox regression analysis was used to investigate independent predictors of long-term all-cause mortality.
Results:
In this study of 4446 patients with AMI, 2223 patients with MASLD were matched with patients without MASLD using propensity scores. The mean follow-up duration was 3.4 ± 2.4 years. The MASLD group had higher rates of obesity, diabetes and chronic kidney disease than their counterparts. Patients with MASLD had early excess all-cause mortality (6.8% vs. 3.6%, p < .001) at 30 days, with unfavourable mortality rates sustained in the long-term (18.3% vs. 14.5%, p = .001) compared with those without MASLD. After adjustment, MASLD remained independently associated with higher long-term all-cause mortality (hazard ratio 1.330, 95% confidence interval 1.106-1.598, p = .002).
Conclusion:
MASLD embodies a higher burden of metabolic dysfunction and is an independent predictor of long-term mortality in the AMI population. Its early identification may be beneficial for risk stratification and provide therapeutic targets for secondary preventive strategies in AMI.
Insights
Metabolic dysfunction-associated steatotic liver disease (MASLD) is linked to increased cardiovascular risk. This study found MASLD independently predicts higher long-term mortality in acute myocardial infarction (AMI) patients.
Area of Science:
- Cardiology
- Hepatology
- Metabolic Diseases
Background:
- Patients with metabolic dysfunction-associated steatotic liver disease (MASLD) face elevated cardiovascular disease risk.
- The clinical profile and prognostic impact of MASLD in acute myocardial infarction (AMI) patients remain underexplored.
Purpose of the Study:
- To investigate the clinical characteristics of AMI patients with MASLD.
- To determine the prognostic significance of MASLD in AMI patients regarding long-term mortality.
Main Methods:
- A comparative study of 4446 AMI patients, with 2223 MASLD patients matched to controls using propensity scores.
- MASLD defined by hepatic steatosis (Hepatic Steatosis Index) and metabolic criteria.
- Kaplan-Meier curves and Cox regression analyzed long-term all-cause mortality.
Main Results:
- The MASLD group exhibited higher rates of obesity, diabetes, and chronic kidney disease.
- MASLD patients had significantly higher 30-day (6.8% vs. 3.6%) and long-term (18.3% vs. 14.5%) all-cause mortality.
- MASLD was an independent predictor of increased long-term mortality (HR 1.330, p=0.002) after adjustment.
Conclusions:
- MASLD signifies a greater metabolic burden and is an independent predictor of mortality in AMI patients.
- Early identification of MASLD can aid risk stratification and guide secondary prevention strategies for AMI.
