Key result
Metabolic dysfunction-associated steatotic liver disease was associated with the presence of any coronary plaque compared to individuals without steatotic liver disease or cardiometabolic criteria.
Why the study?
Differences in cardiovascular events across steatotic liver disease (SLD) subtypes have been shown, but detailed data on coronary artery status were lacking.
Does metabolic dysfunction-associated steatotic liver disease increase the risk of subclinical coronary atherosclerosis in asymptomatic individuals without known coronary artery disease?
Cohort (n=8,622)
No
Does metabolic dysfunction-associated steatotic liver disease increase the risk of subclinical coronary atherosclerosis in asymptomatic individuals without known coronary artery disease?
Answers are grounded in this paper and cite their sources.
Metabolic dysfunction-associated steatotic liver disease (MASLD) and Met-ALD are significantly associated with a higher burden of subclinical coronary atherosclerosis and obstructive CAD on CCTA in asymptomatic individuals.
Previous population-based studies have demonstrated differences in cardiovascular events according to the new classification of steatotic liver disease (SLD). However, detailed data on coronary artery status have not been presented. We aimed to investigate the association between subtypes of SLD and coronary artery status using findings from coronary computed tomography angiography (CCTA). We analyzed 8622 asymptomatic individuals without coronary artery disease (CAD) who underwent both abdominal ultrasonography and CCTA. Study participants were divided into four groups: 934 in the no SLD without cardiometabolic (CM) criteria group, 4811 in the no SLD with CM criteria group, 2494 in the metabolic dysfunction-associated steatotic liver disease (MASLD) group, and 252 in the MASLD with increased alcohol intake (Met-ALD) group. Obstructive CAD was defined as coronary arterial stenosis ≥ 50%. Compared with the no SLD without CM group, the no SLD with CM, MASLD, and Met-ALD groups were significantly associated with any coronary plaque (multivariable-adjusted OR 2.05 [95% CI 1.67-2.52], 2.71 [2.18-3.35], and 2.36 [1.69-3.31], respectively); calcified plaques (1.97 [1.59-2.43], 2.54 [2.04-3.16], and 2.10 [1.49-2.96], respectively); non-calcified plaques (2.04 [1.28-3.25], 2.42 [1.51-3.89], and 3.26 [1.73-6.13], respectively); and obstructive CAD (2.57 [1.53-4.32], 3.64 [2.15-6.16], and 3.51 [1.73-7.10], respectively) (p for all < 0.05). In addition, the inverse probability of treatment weighting (IPTW) analyses showed similar ORs for coronary plaques and obstructive CAD. Additionally, higher steatosis-associated fibrosis estimator (SAFE) was strongly associated with all atherosclerotic plaques and obstructive CAD. This association remained significant after multivariable adjustment and IPTW analyses. Subtypes of SLD had significant, yet different strengths of associations with subclinical coronary atherosclerosis. SAFE score classification effectively stratified the distinct associations with subclinical atherosclerosis in subjects with MASLD.
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Jeong et al. (2025) conducted a cohort in Subclinical coronary atherosclerosis (n=8,622). Metabolic dysfunction-associated steatotic liver disease (MASLD) vs. No steatotic liver disease without cardiometabolic criteria was evaluated on Any coronary plaque (OR 2.71, 95% CI 2.18-3.35, p=<0.001). Metabolic dysfunction-associated steatotic liver disease was associated with the presence of any coronary plaque compared to individuals without steatotic liver disease or cardiometabolic criteria.
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