Acute myocardial infarction in a young female patient with fatty liver disease associated with metabolic dysfunction (MAFLD)
https://doi.org/10.21886/2712-8156-2025-6-4-124-131
Abstract
The analysis of this clinical case is aimed at understanding the contribution of metabolic diseases to the development and further course of acute myocardial infarction. Non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) have been proven to be closely linked to cardiovascular disease, especially coronary heart disease. Hepatic steatosis associated with metabolic dysfunction is a growing public health problem. Metabolic dysfunction and associated insulin resistance are associated with an increased risk of endothelial dysfunction and systemic inflammatory response. This complex pathophysiology accelerates atherogenic dyslipidemia, atherogenesis, diastolic dysfunction, and cardiac arrhythmias. An in-depth study of the problems of unified pathogenetic mechanisms in comorbid patients will allow timely prevention of the development of acute events in the course of chronic non-communicable diseases.
About the Authors
E. V. Noskova
Kirov State Medical University;
Kirov Regional Clinical Hospital
Russian Federation
Russian Federation
Elena V. Noskova, Cand. Sci. (Med.), assistant Professor of Hospital Therapy, Kirov State Medical University; cardiologist at the Department of Emergency Cardiology, Kirov Regional Clinical Hospital
Kirov
Zh. G. Simonova
Kirov State Medical University
Russian Federation
Russian Federation
Zhanna G. Simonova, Dr. Sci. (Med.), Professor, Professor, Head of the Department of Hospital Therapy
Kirov
References
1. Arora S, Stouffer GA, Kucharska-Newton AM, Qamar A, Vaduganathan M, Pandey A, et al. Twenty Year Trends and Sex Differences in Young Adults Hospitalized With Acute Myocardial Infarction. Circulation. 2019;139(8):1047-1056. doi: 10.1161/CIRCULATIONAHA.118.037137
2. Engin A. The Definition and Prevalence of Obesity and Metabolic Syndrome. Adv Exp Med Biol. 2017;960:1-17. doi: 10.1007/978-3-319-48382-5_1
3. Noubiap JJ, Nansseu JR, Lontchi-Yimagou E, Nkeck JR, Nyaga UF, Ngouo AT, et al. Geographic distribution of metabolic syndrome and its components in the general adult population: A meta-analysis of global data from 28 million individuals. Diabetes Res Clin Pract. 2022;188:109924. doi: 10.1016/j.diabres.2022.109924
4. Shvarts V. Inflammation of adipose tissue. Part 3. Pathogenetic role in the development of atherosclerosis. Problems of Endocrinology. 2009;55(6):40-45. (In Russ.) doi: 10.14341/probl200955640-45
5. Mollace R, Longo S, Nardin M, Tavernese A, Musolino V, Cardamone A, et al. Role of MASLD in CVD: A review of emerging treatment options. Diabetes Res Clin Pract. 2024;217:111891. doi: 10.1016/j.diabres.2024.111891
6. Zhou XD, Cai J, Targher G, Byrne CD, Shapiro MD, Sung KC, et al. Metabolic dysfunction-associated fatty liver disease and implications for cardiovascular risk and disease prevention. Cardiovasc Diabetol. 2022;21(1):270. doi: 10.1186/s12933-022-01697-0
7. Mellemkjær A, Kjær MB, Haldrup D, Grønbæk H, Thomsen KL. Management of cardiovascular risk in patients with metabolic dysfunction-associated steatotic liver disease. Eur J Intern Med. 2024;122:28-34. doi: 10.1016/j.ejim.2023.11.012
8. Bansal SK, Bansal MB. Pathogenesis of MASLD and MASH - role of insulin resistance and lipotoxicity. Aliment Pharmacol Ther. 2024;59 Suppl 1:S10-S22. doi: 10.1111/apt.17930
9. Eslam M, Newsome PN, Sarin SK, Anstee QM, Targher G, Romero-Gomez M, et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol. 2020;73(1):202-209. doi: 10.1016/j.jhep.2020.03.039
10. Liu HH, Cao YX, Jin JL, Hua Q, Li YF, Guo YL, et al. Liver Fibrosis Scoring Systems as Novel Tools for Predicting Cardiovascular Outcomes in Patients Following Elective Percutaneous Coronary Intervention. J Am Heart Assoc. 2021;10(3):e018869. doi: 10.1161/JAHA.120.018869
11. Ciavarella A, Gnocchi D, Custodero C, Lenato GM, Fiore G, Sabbà C, et al. Translational insight into prothrombotic state and hypercoagulation in nonalcoholic fatty liver disease. Thromb Res. 2021;198:139-150. doi: 10.1016/j.thromres.2020.12.002
12. Stahl EP, Dhindsa DS, Lee SK, Sandesara PB, Chalasani NP, Sperling LS. Nonalcoholic Fatty Liver Disease and the Heart: JACC State-of-the-Art Review. J Am Coll Cardiol. 2019;73(8):948-963. doi: 10.1016/j.jacc.2018.11.050
13. Pacana T, Cazanave S, Verdianelli A, Patel V, Min HK, Mirshahi F, et al. Dysregulated Hepatic Methionine Metabolism Drives Homocysteine Elevation in Diet-Induced Nonalcoholic Fatty Liver Disease. PLoS One. 2015;10(8):e0136822. doi: 10.1371/journal.pone.0136822
14. Hörber S, Lehmann R, Stefan N, Machann J, Birkenfeld AL, Wagner R, et al. Hemostatic alterations linked to body fat distribution, fatty liver, and insulin resistance. Mol Metab. 2021;53:101262. doi: 10.1016/j.molmet.2021.101262
15. Verrijken A, Francque S, Mertens I, Prawitt J, Caron S, Hubens G, et al. Prothrombotic factors in histologically proven nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. Hepatology. 2014;59(1):121-129. doi: 10.1002/hep.26510
16. Alshammary AF, Alharbi KK, Alshehri NJ, Vennu V, Ali Khan I. Metabolic Syndrome and Coronary Artery Disease Risk: A Meta-Analysis of Observational Studies. Int J Environ Res Public Health. 2021;18(4):1773. doi: 10.3390/ijerph18041773
17. Montazerifar F, Bolouri A, Mahmoudi Mozaffar M, Karajibani M. The Prevalence of Metabolic Syndrome in Coronary Artery Disease Patients. Cardiol Res. 2016;7(6):202-208. doi: 10.14740/cr507w
18. Chan WK, Chuah KH, Rajaram RB, Lim LL, Ratnasingam J, Vethakkan SR. Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A State-of-the-Art Review. J Obes Metab Syndr. 2023;32(3):197-213. doi: 10.7570/jomes23052
19. Vieira Barbosa J, Milligan S, Frick A, Broestl J, Younossi Z, Afdhal N, et al. Fibrosis-4 Index Can Independently Predict Major Adverse Cardiovascular Events in Nonalcoholic Fatty Liver Disease. Am J Gastroenterol. 2022;117(3):453-461. doi: 10.14309/ajg.0000000000001606
20. Simon TG, Corey KE, Cannon CP, Blazing M, Park JG, O'Donoghue ML, et al. The nonalcoholic fatty liver disease (NAFLD) fibrosis score, cardiovascular risk stratification and a strategy for secondary prevention with ezetimibe. Int J Cardiol. 2018;270:245-252. doi: 10.1016/j.ijcard.2018.05.087
21. Kotronen A, Joutsi-Korhonen L, Sevastianova K, Bergholm R, Hakkarainen A, Pietiläinen KH, et al. Increased coagulation factor VIII, IX, XI and XII activities in non-alcoholic fatty liver disease. Liver Int. 2011;31(2):176-183. doi: 10.1111/j.1478-3231.2010.02375.x
22. Noskova E.V., Simonova Zh.G., Balandina Yu.A. Phenotype of bronchial asthma with obesity in combination with chronic coronary heart disease. South Russian Journal of Therapeutic Practice. 2023;4(2):64-72. (In Russ.) doi: 10.21886/2712-8156-2023-4-2-64-72
Review
For citations:
Noskova E.V., Simonova Zh.G. Acute myocardial infarction in a young female patient with fatty liver disease associated with metabolic dysfunction (MAFLD). South Russian Journal of Therapeutic Practice. 2025;6(4):124-131. (In Russ.) https://doi.org/10.21886/2712-8156-2025-6-4-124-131
Views:
61
Email this article 