Previously submitted to: JMIR Cardio (no longer under consideration since Mar 13, 2026)
Date Submitted: Mar 11, 2026
Open Peer Review Period: Mar 13, 2026 - Mar 13, 2026
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Cardiovascular Risk in Patients With and Without Metabolic Dysfunction-Associated Steatotic Liver Disease: A Clinical and Subclinical Evaluation
ABSTRACT
Background:
Metabolic dysfunction-associated steatotic liver disease (MASLD) previously referred to as non-alcoholic fatty liver disease (NAFLD), has become one of the most prevalent metabolic disorders worldwide. Its continued rise in global prevalence has drawn concern from many researchers. Current literature describes MASLD as a liver disease in conjunction with a cardiovascular disease (CVD) which is the most striking cause of mortality in MASLD patients. The purpose of this review is to explore the association of cardiovascular risk and MASLD and its impact on the general population and its patients with cardiovascular disease as well as MASLD and its clinical and subclinical manifestations of cardiovascular disease in affected individuals.
Objective:
The purpose of this review is to explore the association of cardiovascular risk and MASLD and its impact on the general population and its patients with cardiovascular disease as well as MASLD and its clinical and subclinical manifestations of cardiovascular disease in affected individuals.
Methods:
A narrative review of the current literature was conducted to evaluate available evidence regarding the association between MASLD and cardiovascular disease. Published studies addressing epidemiology, pathophysiological mechanisms, clinical outcomes, and markers of subclinical cardiovascular disease in MASLD patients were analyzed and synthesized.
Results:
The evidence shows that patients with MASLD have a clinical and substantial increase in risk of all forms of cardiovascular disease, most specifically coronary artery disease, heart failure, ischemic stroke, and, atrial fibrillation. There are numerous pathways that could be responsible for this relationship one or more of the following: insulin resistance, systemic inflammation, dyslipidemia, and, endothelial dysfunction. There are numerous subclinical cardiovascular changes that are present in a majority of MASLD patients. Many of these unrecognized changes can be assessed with non-invasive tests such as, increased carotid artery stiffness, a positive coronary artery calcium score, and hyperplasia of the epicardial fatty and other tissues.Furthermore, the severity of liver fibrosis appears to be a strong independent predictor of cardiovascular outcomes.
Conclusions:
The diagnosis of Metabolic dysfunction-associated fatty liver disease (MAFLD) predicts patients will develop Cardiovascular disease at rates which exceed those people who do not have this condition. The link between these conditions emerges because metabolic problems which include insulin resistance and obesity and dyslipidemia and chronic low-grade inflammation lead to both liver damage and cardiovascular health problems. Research findings reveal that patients who have MAFLD develop more frequent atherosclerosis and cardiovascular incidents than those who do not have this disease. The research results show that MAFLD functions as a metabolic disorder indicator while it independently raises the chances of developing cardiovascular disease. Clinical Trial: --
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