The Prevalence of Metabolic Dysfunction-Associated Fatty Liver Disease and Its Association with Physical Function and Prognosis in Patients with Acute Coronary Syndrome

Abstract

It is believed that patients with acute coronary syndrome (ACS) are at an increased risk of nonalcoholic fatty liver disease (NAFLD), which can lead to sarcopenia and physical dysfunction. However, the relationship between metabolic dysfunction-associated fatty liver disease (MAFLD) and physical dysfunction and prognosis remains unclear. We investigated the prevalence of MAFLD in patients with ACS to assess the relationship between MAFLD and muscle strength, walking speed, and 6-min walking distance (6 MWD). We reviewed patients with ACS who were assessed for hepatic steatosis using the fatty liver index, and the results were further assessed to determine the presence of MAFLD. Among 479 enrolled hospitalized patients, MAFLD was identified in 234 (48.9%) patients. Multiple regression analysis revealed that MAFLD was independently associated with lower leg strength, gait speed, and 6 MWD (leg strength, p = 0.020; gait speed, p = 0.003 and 6 MWD, p = 0.011). Furthermore, in multivariate Poisson regression models after adjustment for clinical confounding factors, combined MAFLD and reduced physical functions were significantly associated with a higher incidence of clinical events. MAFLD is common in hospitalized patients with ACS and is associated with impaired physical function. Also, the coexistence of MAFLD and lower physical function predict the incidence of clinical events in patients with ACS.

An international multidisciplinary consensus statement on MAFLD and the risk of CVD

“…In a cohort study of 3,306 patients with chronic coronary syndrome, Liu et al [ 58 ] reported that patients with MAFLD had a higher risk of adverse CVD outcomes compared to their counterparts without MAFLD. In a prospective analysis of nearly 500 hospitalized patients with acute coronary syndrome and hepatic steatosis, Noda et al [ 59 ] found that the coexistence of MAFLD and impaired physical function tests independently predicted the risk of adverse CVD outcomes. Finally, some cohort studies found that the MAFLD-only status was more strongly associated with risk of nonfatal CVD events than the NAFLD-only status [ 10 , 35 , 36 , 60 ].…”

From NAFLD to MAFLD: Definition, Pathophysiological Basis and Cardiovascular Implications

“…Moreover, MAFLD was found to be a common clinician condition in hospitalized patients with acute coronary syndrome (ACS) and was related to impaired physical function [ 62 ]. The incidence of new clinical events in patients with ACS was higher in those displaying MAFLD and lower physical function [ 62 ].…”

Features of myocardial infarction with ST segment elevation in patients with non-alcoholic liver steatosis and steatohepatitis

“…Ермилов 2,3 , П.К. Алферов 2,3 Цель. Оценка особенностей инфаркта миокарда с подъемом сегмента ST (ИМпST) у больных с метаболическим синдромом при наличии различных форм метаболически-ассоциированной жировой болезни печени (МАЖБП)стеатоза печени и стеатогепатита.…”

“…Метаболически-ассоциированная жировая болезнь печени (МАЖБП, старое название -неалкогольная жировая болезнь печени), развивающаяся в рамках метаболической дисфункции организма, рассматривается как фактор риска острого коронарного синдрома (ОКС) и может оказывать влияние на течение инфаркта миокарда (ИМ) [1]. В ряде исследований доказано, что у пациентов с МАЖБП наблюдается более тяжелое поражение коронарных артерий [2][3][4]. Тем не менее, связь между стеатозом печени и стеатогепатитом, т.е.…”