Outcomes of percutaneous coronary intervention among patients with metabolic dysfunction-associated steatotic liver disease: A nationwide study

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology Pub Date : 2025-05-01 DOI:10.1016/j.jacl.2025.04.084

Derek Ugwendum MD, Aseed Mestarihi MD, Oluwatoyosi Awotorebo MD, Ikponmwosa Ogieuhi MD, Karldon Nwaezeapu MD, Godbless Ajenaghughrure MD, Anuoluwa Oyetoran MD, Kayode Ogunniyi MBBS

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引用次数: 0

Abstract

Background/Synopsis

Metabolic dysfunction-assoc-iated steatotic liver disease (MASLD) is increasingly recognized as a multisystemic disorder and an independent risk factor for cardiovascular disease. Although MASLD has been implicated in worsened atherosclerosis, its direct impact on percutaneous coronary intervention (PCI) outcomes remains uncertain.

Objective/Purpose

To evaluate whether MASLD (in the absence of cirrhosis, alcohol use disorder, or alcoholic fatty liver) affects in-hospital outcomes among patients undergoing PCI.

Methods

Using data from the 2021 National Inpatient Sample, we identified patients who underwent PCI and classified them based on MASLD status, as determined by the International Classification of Diseases codes (ICD-10 codes). We excluded patients with co-existing alcohol use disorder, alcoholic fatty liver disease, or cirrhosis. Outcomes of interest were in-hospital mortality, vasopressor requirements, length of hospital stay, and total hospital charges. Multivariate logistic regression models, adjusted for age, sex, and Charlson comorbidity index, were used to assess the association between MASLD and these outcomes.

Results

A total of 314,505 patients underwent PCI, of whom 4,320 (1.4%) had MASLD. These patients were younger (median age 61 vs. 66 years; p < 0.001) but had a higher comorbidity burden (Charlson comorbidity index of 3.9 vs. 2.8; p < 0.001), with no significant difference in gender distribution. In unadjusted analyses, there were no differences in in-hospital mortality (p = 0.725) or vasopressor requirement (p = 0.376). Patients with MASLD experienced a slightly longer hospital stay (additional 0.47 days; p = 0.02) and higher total charges (+8,496 USD; p = 0.039). After adjustment for confounders, MASLD was not associated with increased in-hospital mortality (p = 0.634), vasopressor requirement (p = 0.234), length of stay (p = 0.102), or total hospital charges (p = 0.514).

Conclusions

In this nationwide cohort, MASLD was not independently associated with adverse in-hospital outcomes following PCI. Despite having a higher comorbidity burden, patients with MASLD did not experience increased in-hospital mortality or need for vasopressors. Further research is warranted to explore the long-term implications of MASLD on PCI outcomes

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代谢功能障碍相关脂肪变性肝病患者经皮冠状动脉介入治疗的结果：一项全国性研究

背景/摘要代谢功能障碍相关脂肪变性肝病（MASLD）越来越被认为是一种多系统疾病和心血管疾病的独立危险因素。尽管MASLD与动脉粥样硬化恶化有关，但其对经皮冠状动脉介入治疗（PCI）结果的直接影响仍不确定。目的/目的评价MASLD（无肝硬化、酒精使用障碍或酒精性脂肪肝）是否影响PCI患者的住院结局。方法使用来自2021年全国住院患者样本的数据，我们确定了接受PCI的患者，并根据MASLD状态对其进行分类，根据国际疾病分类代码（ICD-10代码）确定。我们排除了同时存在酒精使用障碍、酒精性脂肪性肝病或肝硬化的患者。研究的结果包括住院死亡率、血管加压药需求、住院时间和医院总收费。采用多变量logistic回归模型，调整年龄、性别和Charlson合并症指数，评估MASLD与这些结果之间的关系。结果314505例患者行PCI，其中MASLD 4320例（1.4%）。这些患者较年轻(中位年龄61岁vs. 66岁；p & lt;0.001)，但合并症负担较高(Charlson合并症指数为3.9比2.8；p & lt;0.001)，性别分布无显著差异。在未经调整的分析中，住院死亡率（p = 0.725）和血管加压素需要量（p = 0.376）没有差异。MASLD患者的住院时间稍长(额外0.47天；p = 0.02)和更高的总费用(+8,496美元； = 0.039页)。调整混杂因素后，MASLD与住院死亡率（p = 0.634）、血管加压素需要量（p = 0.234）、住院时间（p = 0.102）或总住院费用（p = 0.514）增加无关。结论：在这个全国性队列中，MASLD与PCI术后不良住院结果没有独立关联。尽管有更高的合并症负担，MASLD患者没有增加住院死亡率或对血管加压药物的需求。有必要进一步研究MASLD对PCI预后的长期影响

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来源期刊

Journal of clinical lipidology 医学-药学

CiteScore

7.00

自引率

6.80%

发文量

209

审稿时长

49 days

期刊介绍： Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. Sections of Journal of clinical lipidology will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.