{
  "abstract": "Background Metabolic dysfunction-associated steatotic liver disease (MASLD) is a well-established driver of cardiovascular disease (CVD). However, the subsequent risk of liver-related events (LREs) after CVD is often overlooked. We investigated whether incident CVD elevates long-term LRE risk in MASLD patients.Methods We used UK Biobank data to determine whether incident CVD (the exposure; coronary heart disease [CHD], myocardial infarction [MI], heart failure [HF], or atrial fibrillation [AF]) raises the risk of LREs (the outcome; including complications such as new-onset cirrhosis, liver failure or hepatocellular carcinoma) in MASLD patients. A semi-Markov multi-state model estimated transition rates, and time-dependent Cox regression models calculated adjusted hazard ratios (aHR) for LREs risk. Additionally, imaging and proteomic data were analyzed to explore biological mechanisms ( IDDF2026-ABS-0362 Figure 1).Results Among 142,454 MASLD patients, 22,630 (15.9%) developed incident CVD, and 2,635 (1.8%) progressed to LREs over a median of 15.1 years. The transition rates from CVD to LREs were higher than the direct progression from MASLD to LREs (3.56 vs. 1.08 per 1,000 person-years, IDDF2026-ABS-0362 Figure 2). The risk varied by CVD subtype, being highest for HF, followed by AF, CHD, and MI (IDDF2026-ABS-0362 Figure 3). Time-dependent Cox regression confirmed that incident CVD independently increased the risk of subsequent LREs (aHR: 1.93, 95% CI: 1.73–2.14, IDDF2026-ABS-0362 Figure 4). Integrated multi-omics analyses revealed correlations between cardiac dysfunction and hepatic parameters (IDDF2026-ABS-0362 Figure 5), and a shared proteomic signature enriched in immune and fibrotic pathways (IDDF2026-ABS-0362 Figure 6).Conclusions Patients with MASLD who experience a CVD have a higher risk of long-term LREs, highlighting the importance of monitoring liver health and initiating early treatment after CVD.Abstract IDDF2026-ABS-0362 Figure 1Abstract IDDF2026-ABS-0362 Figure 2Abstract IDDF2026-ABS-0362 Figure 3Abstract IDDF2026-ABS-0362 Figure 4Abstract IDDF2026-ABS-0362 Figure 5Abstract IDDF2026-ABS-0362 Figure 6",
  "authors": [
    {
      "affiliations": [
        "The First Affiliated Hospital of Wenzhou Medical University, China"
      ],
      "name": "Li-You Lian"
    },
    {
      "affiliations": [
        "The First Affiliated Hospital of Wenzhou Medical University, China"
      ],
      "name": "Qin-Fen Chen"
    },
    {
      "affiliations": [
        "Zhongda Hospital, Medical School of Southeast University, China"
      ],
      "name": "Tianyi Xia"
    },
    {
      "affiliations": [
        "The First Affiliated Hospital of Wenzhou Medical University, China"
      ],
      "name": "Chen-Xiao Huang"
    },
    {
      "affiliations": [
        "The First Affiliated Hospital of Wenzhou Medical University, China"
      ],
      "name": "Yi-Xuan Wei"
    },
    {
      "affiliations": [
        "University of Verona, Italy"
      ],
      "name": "Giovanni Targher"
    },
    {
      "affiliations": [
        "Southampton General Hospital, United Kingdom"
      ],
      "name": "Christopher D Byrne"
    },
    {
      "affiliations": [
        "Emory Clinical Cardiovascular Research Institute, United States"
      ],
      "name": "Laurence S Sperling"
    },
    {
      "affiliations": [
        "Aalborg University, Denmark"
      ],
      "name": "Gregory YH Lip"
    },
    {
      "affiliations": [
        "Peking University, China"
      ],
      "name": "Yuanjie Pang"
    },
    {
      "affiliations": [
        "Capital Medical University, China"
      ],
      "name": "Shan-Shan Wu"
    },
    {
      "affiliations": [
        "Zhongda Hospital, Medical School of Southeast University, China"
      ],
      "name": "Shenghong Ju"
    },
    {
      "affiliations": [
        "The First Affiliated Hospital of Wenzhou Medical University, China"
      ],
      "name": "Xiao-Dong Zhou"
    },
    {
      "affiliations": [
        "The First Affiliated Hospital of Wenzhou Medical University, China"
      ],
      "name": "Ming-Hua Zheng"
    }
  ],
  "title": "IDDF2026-ABS-0362 Trajectory of liver-related events following incident cardiovascular disease in MASLD: a 15-year population-based cohort study",
  "uid": "3939189e-69aa-52a3-ac9e-babe2fdf92a7"
}