Comparison of Clinical Outcomes in Patients With Acute Myocardial Infarction Between Those With and Without Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD).

Background: Acute myocardial infarction (AMI) is a fatal cardiovascular disease with varying prognosis. Recent studies suggest a close relationship between cardiovascular disease and metabolic dysfunction-associated fatty liver disease (MAFLD), but because the prognostic value of MAFLD in patients with AMI remains unclear, we investigated the relationship between MAFLD and clinical outcomes in patients with AMI. Methods and Results: This retrospective study included 1,142 patients with AMI who underwent percutaneous coronary intervention (PCI) to the culprit lesion of AMI and were classified as MAFLD (n=231) and non-MAFLD (n=911). Hepatic steatosis was diagnosed by a liver-to-spleen attenuation (L/S) ratio <1 on computed tomography. The primary outcome was major adverse cardiovascular events (MACE), which were defined as a composite of all-cause death, non-fatal MI, and readmission for heart failure. Over a median follow-up of 609 days, MACE was less frequently observed in the MAFLD group than in the non-MAFLD group (P=0.015). However, the multivariate Cox hazard analysis showed that MAFLD was not associated with MACE (hazard ratio 0.80, 95% confidence interval 0.564-1.140, P=0.219) after controlling for confounding factors. Conclusions: We could not show a significant association between MAFLD and MACE in patients with AMI, suggesting the absence of strong association between MAFLD and long-term clinical outcomes in these patients.