Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital, Turin, Italy.
Department of Medical Sciences, University of Turin, Turin, Italy.
Eur J Clin Invest. 2024 Sep;54(9):e14188. doi: 10.1111/eci.14188. Epub 2024 Feb 23.
Metabolic dysfunction associated steatotic liver disease (MASLD) is associated with an increased risk of coronary artery disease. Computed Tomography Coronary Angiography (CTCA) can assess both the extent and the features of coronary plaques. We aimed to gather evidence about the prevalence and features of coronary plaques among MASLD patients.
PubMed, Scopus, and Google Scholar databases were searched for randomized controlled trials and adjusted observational studies assessing the prevalence and features of coronary plaques by means of CTCA in MASLD patients as compared with a control group. The prevalence of coronary stenosis (defined as >30% and >50% diameter of stenosis), of increasing coronary artery calcium (CAC) score and of high-risk features (namely low-attenuation plaques, napkin ring sign, spotty calcification and positive remodelling) in MASLD patients were the endpoints of interest.
Twenty-four observational studies were included. MASLD was associated with an increased prevalence of critical coronary stenosis compared with controls (odds ratio [OR] 1.54, 95%CI 1.23-1.93). Increased values of CAC score were observed in MASLD patients (OR 1.35, 95%CI 1.02-1.78 and OR 2.26, 95%CI 1.57-3.23 for CAC score 0-100 and >100, respectively). An increased risk of 'high-risk' coronary plaques was observed in MASLD patients (OR 2.13, 95%CI 1.42-3.19). As high-risk features plaques, a higher prevalence of positive remodelling and spotty calcification characterize MASLD patients (OR 2.92, 95%CI 1.79-4.77 and OR 2.96, 95%CI 1.22-7.20).
Patients with MASLD are at increased risk of developing critical coronary stenosis and coronary plaques characterized by high-risk features as detected by CTCA.
代谢功能障碍相关脂肪性肝病（MASLD）与冠状动脉疾病的风险增加相关。计算机断层扫描冠状动脉造影（CTCA）可评估冠状动脉斑块的程度和特征。我们旨在收集有关 MASLD 患者冠状动脉斑块发生率和特征的证据。
在 PubMed、Scopus 和 Google Scholar 数据库中检索了评估 MASLD 患者与对照组相比通过 CTCA 检测冠状动脉斑块发生率和特征的随机对照试验和调整观察性研究。感兴趣的终点包括冠状动脉狭窄（定义为>30%和>50%的狭窄直径）、冠状动脉钙（CAC）评分增加和高危特征（即低衰减斑块、餐巾环征、点状钙化和正性重构）的发生率。
共纳入 24 项观察性研究。与对照组相比，MASLD 患者发生严重冠状动脉狭窄的比例更高（比值比[OR] 1.54，95%置信区间[CI] 1.23-1.93）。MASLD 患者的 CAC 评分值增加（OR 1.35，95%CI 1.02-1.78 和 OR 2.26，95%CI 1.57-3.23，分别用于 CAC 评分 0-100 和>100）。MASLD 患者发生“高危”冠状动脉斑块的风险增加（OR 2.13，95%CI 1.42-3.19）。作为高危特征斑块，MASLD 患者中更常见正性重构和点状钙化（OR 2.92，95%CI 1.79-4.77 和 OR 2.96，95%CI 1.22-7.20）。
MASLD 患者发生严重冠状动脉狭窄和 CTCA 检测到的高危特征冠状动脉斑块的风险增加。
