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Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jul 26, 2025; 17(7): 107751
Published online Jul 26, 2025. doi: 10.4330/wjc.v17.i7.107751
Integrating liver and heart health: Cardiovascular risk reduction in patients with metabolic-associated steatotic liver disease
Thang Viet Luong, Hoa Tran, Bich Ngoc Hoang Thi, Hung Minh Vu, The Trung Le, Tien Thi Le, Huyen Trang Tran Thi, Hung Minh Nguyen, Thang Chi Doan, Binh Anh Ho, Tien Anh Hoang, Hai Nguyen Ngoc Dang
Thang Viet Luong, Hung Minh Vu, Tien Anh Hoang, Department of Internal Medicine, University of Medicine and Pharmacy, Hue University, Hue 530000, Viet Nam
Hoa Tran, Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh 700000, Viet Nam
Hoa Tran, Cardiovascular Center, University Medical Center, Ho Chi Minh 700000, Viet Nam
Bich Ngoc Hoang Thi, Department of Outpatient, Gia An 115 Hospital, Ho Chi Minh City 700000, Viet Nam
The Trung Le, Tien Thi Le, Department of Nephrology and Endocrinology, Da Nang Hospital, Da Nang 550000, Viet Nam
Huyen Trang Tran Thi, Department of Endocrinology and Clinical Hematology, 199 Hospital, Da Nang 550000, Viet Nam
Hung Minh Nguyen, Vietnam National Heart Institute, Bach Mai Hospital, Ha Noi 100000, Viet Nam
Thang Chi Doan, Binh Anh Ho, Cardiovascular Center, Hue Central Hospital, Hue 530000, Viet Nam
Hai Nguyen Ngoc Dang, Faculty of Medicine, Duy Tan University, Da Nang 550000, Viet Nam
Co-first authors: Thang Viet Luong and Hoa Tran.
Co-corresponding authors: Tien Anh Hoang and Hai Nguyen Ngoc Dang.
Author contributions: Luong TV and Tran H were responsible for conceptualizing the study and writing the original draft of the manuscript; Vu HM contributed to the drafting and revision of the manuscript; Luong TV and Tran H contributed equally to this work as co-first authors. Their joint efforts ensured both the scientific rigor and clarity of the manuscript. Dang HNN and Hoang TA are designated as co-corresponding authors due to their essential and complementary contributions throughout the research and publication process. Specifically, Dang HNN coordinated interdisciplinary collaboration, maintained communication with institutional partners, supervised the revision process, and led the development of figures. Hoang TA was responsible for overseeing data collection, and co-designing the visual presentation of results. All authors contributed to writing, reviewing, and approving the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai Nguyen Ngoc Dang, Lecturer, MD, Researcher, Faculty of Medicine, Duy Tan University, 254 Nguyen Van Linh, Da Nang 550000, Viet Nam. ngochai123dc@gmail.com
Received: March 30, 2025
Revised: May 10, 2025
Accepted: July 8, 2025
Published online: July 26, 2025
Processing time: 116 Days and 1.9 Hours
Abstract

Metabolic-associated steatotic liver disease (MASLD) is a global health burden intricately linked to cardiovascular disease (CVD) through shared pathways-insulin resistance, dyslipidemia, and chronic inflammation. CVD has become the leading cause of mortality in MASLD, necessitating integrated management strategies. This review synthesizes evidence on bidirectional MASLD-CVD interactions and evaluates therapeutic approaches: Lifestyle modifications, pharmacotherapy (e.g., GLP-1 receptor agonists, SGLT2 inhibitors, statins), and metabolic interventions. Despite progress, critical gaps persist in risk stratification tools, personalized treatment algorithms, and long-term outcomes of novel agents like resmetirom. A multidisciplinary care model, bridging hepatology and cardiology, is essential to address these challenges and improve patient outcomes.

Keywords: Metabolic-associated steatotic liver disease; Cardiovascular disease; Insulin resistance; GLP-1 receptor agonists; SGLT2 inhibitors; Statins; Bariatric surgery; Multidisciplinary care; Emerging therapies

Core Tip: Metabolic-associated steatotic liver disease (MASLD), a leading global liver disorder, is strongly linked to cardiovascular disease (CVD) through shared pathways including insulin resistance, dyslipidemia, and systemic inflammation. This review examines the bidirectional relationship between MASLD and CVD, highlighting CVD as the primary cause of morbidity and mortality in this population. We evaluate evidence-based management strategies including lifestyle modifications, pharmacotherapy and metabolic interventions, while emphasizing the need for multidisciplinary care. Critical gaps in risk stratification, treatment personalization, and long-term outcomes of emerging therapies are discussed, underscoring the necessity for integrated approaches to improve patient outcomes.