Interdisciplinary perspectives on the co-management of metabolic dysfunction-associated steatotic liver disease and coronary artery disease.

Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as a public health threat as it affects approximately 38% of the adult population worldwide, with its prevalence rising in step with that of obesity and type 2 diabetes. Beyond the implications of MASLD for liver health, it is also associated with cardiovascular and vascular dysfunction. Although the many shared risk factors and common metabolic milieu might indicate that cardiovascular disease and MASLD are discrete outcomes from common systemic pathogeneses, a growing body of evidence has identified a potential causal relationship between MASLD and coronary artery disease, which is the leading cause of morbidity and mortality in people with MASLD and all-cause mortality worldwide. This Review takes an interdisciplinary approach, drawing on hepatology, cardiology, endocrinology, and metabolic and internal medicine specialists to help to delineate the intricate interplay between MASLD and coronary artery disease. It sheds light on novel opportunities for targeted interventions and personalised management strategies.
Competing Interests: Declaration of interests JVL has received grant funding from AbbVie, Boehringer Ingelheim, Echosens, Gilead Sciences, Madrigal, Merck, Sharp, & Dohme (MSD), Novo Nordisk, Pfizer, and Roche Diagnostics; consulting fees from Echosens, Novovax, GlaxoSmithKline, Novo Nordisk, and Pfizer; payment or honoraria for presentations from AbbVie, Echosens, Gilead Sciences, Janssen, Moderna, MSD, Novo Nordisk, and Pfizer; participated on a data safety monitoring board or advisory board; had a leadership or fiduciary role on Healthy Livers, Health Livers (formed by AASLD, ALEH, APASL, EASL, and Global NASH Council); and was HIV Outcomes co-chair, all unrelated to the current study. PNB has received grant funding for the National Institute for Health and Care Research (NIHR); consulting fees for Resolution Therapeutics; payment or honoraria for presentations from Takeda; support for attending meetings for EASL Bursary for EASL International Liver Conference 2024 and EASL Bursary for School of Hepatology, Steatotic Liver Disease, Aarhus; and leadership or fiduciary role in the Global NASH Council; all unrelated to the current study. CCL has received grant funding from the British Heart Foundation, UK Research and Innovation, NIHR, Chief Scientist Office, European Commission, Juvenile Diabetes Research Foundation, Applied Therapeutics, Anacardia, AstraZeneca, Boehringher Ingelheim, Eli Lilly, Moderna, Roche Diagnostics, Novo Nordisk, and Novartis; and has participated on a data safety monitoring board or advisory board with The International Coronary Microvascular Angina study, TIME Study, and the Dapagliflozin, Exercise Training and physicAl function: the DETA trial; all unrelated to the current study. SSV received grant funding from the Department of Veterans Affairs, National Institutes of Health, UK NIHR, Tahir and Jooma Family, and Asharia Family, all unrelated to the current study. CJL has received payment or honoraria for presentations from Amgen, Global Organization for EPA and DHA Omega-3s, and Diagnostic and Statistical Manual of Mental Disorders; and participated on a data safety monitoring board or advisory board with Novo Nordisk; all unrelated to the current study. SI has received payment for expert testimonies and had a leadership or fiduciary role on the American Association of Clinical Endocrinology, all unrelated to the current study. KC received grant funding from Boehringer Ingelheim, Echosens, Inventiva, LabCorp, Perspectum, and Target-NASH; and consulting fees from Aligos Therapeutics, Arrowhead, AstraZeneca, 89Bio, Bristol Myers Squibb, Boehringer Ingelheim, Covance, Eli Lilly & Co, Molecular Genetics & Genomic Medicine, Novo Nordisk, Prosciento, Sagimet Biosciences, Siemens USA, and Terns Pharma, all unrelated to the current study. All other authors declare no competing interests.
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