Orzan Rares Ilie, Gligor Rares Ioan, Agoston Renata, Cionca Carmen, Zlibut Alexandru, Pais Raluca, Seicean Andrada, Agoston-Coldea Lucia
Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania.
Regional Institute of Gastroenterology and Hepatology "Prof. Dr. Octavian Fodor", 400162 Cluj-Napoca, Romania.
J Cardiovasc Dev Dis. 2024 Feb 26;11(3):77. doi: 10.3390/jcdd11030077.
In this single-center cross-sectional study on patients undergoing coronary computed tomography angiography (CCTA), we assessed the prognostic significance of metabolic dysfunction associated steatotic liver disease (MASLD), metabolic syndrome (MetS), and CCTA-derived parameters for predicting major adverse cardiovascular events (MACE). Over a mean follow-up of 26.9 months, 2038 patients were analyzed, with 361 (17.7%) experiencing MACE. MASLD was associated with a higher MACE incidence (25.90% vs. 14.71% without MASLD, < 0.001). Cox regression revealed significant associations between MASLD, coronary calcium score (CCS), number of plaques (NoP), epicardial fat volume (EFV), and MACE, with hazard ratios of 1.843, 1.001, 1.097, and 1.035, respectively ( < 0.001 for all). A composite risk score integrating CCS, NoP, EFV, and MASLD demonstrated superior predictive value for MACE (AUC = 0.948) compared to individual variables ( < 0.0001 for all). In conclusion, MASLD is linked to an elevated risk of MACE, and a comprehensive risk-scoring system incorporating imaging and clinical factors enhances MACE prediction accuracy.
在这项针对接受冠状动脉计算机断层扫描血管造影（CCTA）的患者的单中心横断面研究中，我们评估了代谢功能障碍相关脂肪性肝病（MASLD）、代谢综合征（MetS）以及CCTA衍生参数对预测主要不良心血管事件（MACE）的预后意义。在平均26.9个月的随访期内，对2038例患者进行了分析，其中361例（17.7%）发生了MACE。MASLD与较高的MACE发生率相关（25.90%对无MASLD者的14.71%，<0.001）。Cox回归显示，MASLD、冠状动脉钙化评分（CCS）、斑块数量（NoP）、心外膜脂肪体积（EFV）与MACE之间存在显著关联，危险比分别为1.843、1.001、1.097和1.035（均<0.001）。与单个变量相比，整合CCS、NoP、EFV和MASLD的综合风险评分对MACE具有更高的预测价值（AUC = 0.948）（所有均<0.0001）。总之，MASLD与MACE风险升高相关，纳入影像学和临床因素的综合风险评分系统可提高MACE预测准确性。
