IMPROVEMENT OF CARDIOVASCULAR RISK ASSESSMENT ON A COHORT OF PATIENTS WITH METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE (MASLD)

Introduction and Objectives

Pulse Wave Velocity (PWV) and ultrasound analysis of the carotid and femoral arteries (CA/FA) may offer a more accurate estimation of the cardiovascular risk (CVR) than traditional scores beyond the Coronary Calcium Score. The aim was to evaluate the impact of PWV and Doppler examinations of the CA/FA as modifiers of CVR in MASLD-patients in whom traditional scores were calculated.

Patients and Methods

This was a sectional study in MASLD-outpatients without clinical atherosclerotic disease. The AHA/ACC, Framingham and PREVENT scores were calculated, with a value ≥ 20% considered high-risk. PWV index (patient-PWV/median PWV of the National CVR standard) was assessed (Arteris® AOP), and if ≥ 1 was considered as high-risk. CA/FA Doppler (Affiniti-70, Philips, USA) identified atherosclerotic plaques. The prevalence of high-risk patients was first calculated according to each score and reassessed after PWV and Doppler of CA/FA.

Results

One hundred fifty-three patients were evaluated between Oct-2023 and Mar-2025 (78% women, 60.2 ± 9.4 yrs., 68% obese, 79% SAH, 67% T2DM, 77% dyslipidemia). Regarding overall scores, 32% of patients were classified as high risk (Prevent 15%, AHA/ACC 18%, Framingham 26%). Notably, a high PWV-index was observed in 33%, and 76% had atherosclerotic plaques, characterizing established atherosclerotic disease. The risk reclassification by the PWV-index ocurred in 21%,25%, and 28%, and by the Doppler 53%,60%, and 62%, respectively, for the Framingham, AHA/ACC, and Prevent scores.

Conclusions

Patients with MASLD have a high prevalence of subclinical atherosclerosis. Traditional scores underestimated CVR, highlighting the need for additional methods for better risk stratification.

Conflict of interest: None