Long-term outcomes in acute coronary syndrome patients without standard modifiable risk factors: a multi-ethnic retrospective cohort study Of 5400 asian patients

Hepatic steatosis and advanced hepatic fibrosis are independent predictors of long‐term mortality in acute myocardial infarction

“…Subgroup survival analysis was performed based on AMI type and the absence of standard modifiable cardiovascular risk factors (defined in this study as active smoking, hypertension, hyperlipidaemia and/or diabetes). 15,21,35,36 A P value of .05 or less was considered statistically significant. The study was approved by the local institutional review committee in accordance with the revised Declaration of Helsinki (NHG Research-DSRB: 2021/00089-AMD0001).…”

“…Indeed, this has clinical importance given the emerging evidence of the paradoxical 80% increase in mortality in post-AMI patients without cardiovascular risk factors compared with those with risk factors, evoking a sense of urgency in identifying and treating non-standard modifiable risk factors, such as hepatic steatosis and/or fibrosis, which are beyond the standard atherosclerotic cardiovascular risk predictors. 21,35,36 Targeting common biological mechanisms of metabolic dysregulations that underlie hepatic steatosis and coronary artery disease, through exercise and dietary modifications, can help establish the unified goal in addressing liver and cardiovascular-related endpoints. 63,64 In fact, the plethora of upcoming trials in the search for the first US Food and Drug Administration-approved medication for non-alcoholic steatohepatitis has led to promising data that describe the combined improvement in both liver and cardiovascular-related outcomes with the use of drugs such as peroxisome proliferator-activated receptor agonists, glucagon-like peptide-1 receptor agonists and sodiumglucose co-transporter-2 inhibitors.…”

“…Interestingly, a prospective study on the ultrasound‐proven fatty liver disease cohort revealed that the increase in severity of hepatic steatosis did not confer differences in cardiovascular‐related mortality, but the increase in hepatic fibrosis severity was independently associated with an 8‐fold increase in cardiovascular‐related mortality, 62 thus advancing the notion that fatty liver disease and the degree of its severity are linked with adverse cardiovascular outcomes. Indeed, this has clinical importance given the emerging evidence of the paradoxical 80% increase in mortality in post‐AMI patients without cardiovascular risk factors compared with those with risk factors, evoking a sense of urgency in identifying and treating non‐standard modifiable risk factors, such as hepatic steatosis and/or fibrosis, which are beyond the standard atherosclerotic cardiovascular risk predictors 21,35,36 …”

“…The Kaplan–Meier survival curves for all‐cause mortality were constructed and stratified according to hepatic steatosis and advanced hepatic fibrosis status. Subgroup survival analysis was performed based on AMI type and the absence of standard modifiable cardiovascular risk factors (defined in this study as active smoking, hypertension, hyperlipidaemia and/or diabetes) 15,21,35,36 . A P value of .05 or less was considered statistically significant.…”

General Public’s knowledge, awareness, and perception of Cardiometabolic diseases: data from a Singapore study population

“…Those with MFs had lower knowledge scores on all cardiometabolic domains when compared to their counterparts without MFs. Although it is plausible that the higher baseline knowledge of cardiometabolic diseases has equipped individuals to take preemptive measures early to mitigate the risk of cardiometabolic diseases ( 53 ), this still raises concerns over the discrepancy in the knowledge gap in those living with cardiometabolic diseases ( 54 , 55 ). Despite the increased perceived susceptibility of those with MFs, it is concerning that this did not appear to translate into self-reported actions taken to improve metabolic health.…”