Influence of Metabolic Dysfunction-Associated Steatotic Liver Disease on Pattern and Management of Acute Coronary Syndrome.

Abstract

Objectives: To determine the influence of metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and hepatic fibrosis on the pattern and management of patients who had acute coronary syndrome (ACS).

Methods: Retrospective records of patients with ACS included demographic, electrocardiographic, and laboratory data of platelets count, glycated hemoglobin, lipogram, liver and cardiac enzymes. Ultrasound was used to evaluate fatty liver. Coronary angiography data included the number, site and percentage of the coronary arteries occluded. The type and outcome of treatment of ACS were recorded. Laboratory markers were measured to evaluate fibrosis.

Results: The study recruited 259 patients, and the majority were males. MASLD was detected in 123 (47.5%). The ST segment-elevation myocardial infarction (STEMI) was reported in 42.9% and non-STEMI (NSTEMI) in 30.1%. MASLD patients had frequent STEMI (38.2%) and NSTEMI (31.7%) with more involvement of left main coronary artery (10.6%). Patients with MASLD and higher fibrosis showed involvement of multiple coronary arteries and needed revascularization but without significant difference from non-MASLD. Left anterior descending and right coronary arteries were significantly involved in higher fibrosis.

Conclusion: STEMI and NSTEMI were frequent in MASLD. People with MASLD and hepatic fibrosis had more incidence of occlusion of multiple coronary arteries and needed cardiac intervention.