Quantitative Hepatic Steatosis Is an Independent Predictor of High SYNTAX Score in Patients With Acute Myocardial...

While metabolic dysfunction-associated steatotic liver disease (MASLD) is linked to increased cardiovascular risk, it is unclear if liver fat quantity correlates with coronary artery disease (CAD) complexity during acute myocardial infarction (AMI). We investigated the relationship between hepatic steatosis, measured by the controlled attenuation parameter (CAP), and CAD complexity, quantified by the SYNTAX score, in patients with AMI.

This prospective study enrolled 161 consecutive patients with AMI undergoing coronary angiography. Hepatic steatosis was assessed using CAP through transient elastography (significant steatosis: S2 to S3, ≥268 dB/m). CAD complexity was evaluated using the SYNTAX score (moderate-to-high: ≥23). Multivariate logistic regression identified independent predictors of SYNTAX scores.

Significant steatosis was present in 47.8% of patients. Those with moderate-to-high SYNTAX scores had significantly higher CAP values (276.5 vs. 220.0 dB/m, P=0.001). SYNTAX score correlated positively with CAP (r=0.286, P<0.001). On multivariate analysis, CAP remained an independent predictor of moderate-to-high SYNTAX scores (adjusted OR=1.01 per dB/m, 95% CI: 1.00-1.02, P=0.018).

Quantitatively assessed hepatic steatosis (CAP) is independently associated with complex CAD in patients with AMI. CAP measurement may serve as a simple, noninvasive tool for enhanced cardiovascular risk stratification.