{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:28:03Z","timestamp":1789003683446,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T00:00:00Z","timestamp":1751500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016243","name":"Teikyo University School of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016243","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>There is uncertainty regarding the role of plasma lipoprotein(a) [Lp(a)] in predicting cardiovascular events in patients with metabolic dysfunction\u2010associated steatotic liver disease (MASLD). We examined the association between plasma Lp(a) concentrations and major adverse cardiovascular events (MACE) in MASLD, stratified by the severity of liver fibrosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study enrolled patients with MASLD from two centres. Lp(a) percentile groups were generated with the reference group set at the 1st\u201350th Lp(a) percentiles. High Lp(a) levels correspond to the 91st\u2013100th percentile. Advanced liver fibrosis was defined using the fibrosis (FIB)\u20104 index\u2009&gt;\u20092.67. MACE was defined as myocardial infarction, ischemic stroke, or cardiovascular death. Cox regression was used to assess the association between the Lp(a) percentile groups and MACE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 56\u2009168 patients with MASLD were followed for a median of 5.0\u2009years (IQR: 2.0\u20138.5\u2009years), and 6136 patients developed incident MACE. There was an inverse association between Lp(a) percentiles and advanced liver fibrosis (91st\u2013100th percentile, adjusted OR\u2009=\u20090.65, 95% CI 0.59\u20130.72;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In patients with advanced liver fibrosis, there was a lower proportion in the high Lp(a) levels group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), although the incidence of MACE remained high. MASLD patients with advanced liver fibrosis and high Lp(a) levels had a higher risk of MACE (adjusted HR\u2009=\u20091.56, 95% CI 1.27\u20131.91;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) than those with low Lp(a) levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Plasma Lp(a) levels are lower in MASLD patients with advanced fibrosis, yet their MACE risk remains high, suggesting that relying on Lp(a) alone may underestimate cardiovascular risk if advanced liver fibrosis is not considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70208","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T07:24:54Z","timestamp":1751527494000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Association of Plasma Lipoprotein(a) With Major Adverse Cardiovascular Events in\n                    <scp>MASLD<\/scp>\n                    With or Without Advanced Liver Fibrosis"],"prefix":"10.1111","volume":"45","author":[{"given":"Tie","family":"Xiao","sequence":"first","affiliation":[{"name":"MAFLD Research Centre, Department of Hepatology The First Affiliated Hospital of Wenzhou Medical University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui\u2010Hui","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Cardiometabolic Centre, State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Tian","sequence":"additional","affiliation":[{"name":"MAFLD Research Centre, Department of Hepatology The First Affiliated Hospital of Wenzhou Medical University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010You","family":"Lian","sequence":"additional","affiliation":[{"name":"MAFLD Research Centre, Department of Hepatology The First Affiliated Hospital of Wenzhou Medical University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai\u2010Wen","family":"Miao","sequence":"additional","affiliation":[{"name":"MAFLD Research Centre, Department of Hepatology The First Affiliated Hospital of Wenzhou Medical University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Ting","family":"Li","sequence":"additional","affiliation":[{"name":"MAFLD Research Centre, Department of Hepatology The First Affiliated Hospital of Wenzhou Medical University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Li","family":"Chen","sequence":"additional","affiliation":[{"name":"MAFLD Research Centre, Department of Hepatology The First Affiliated Hospital of Wenzhou Medical University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai\u2010Yang","family":"Yuan","sequence":"additional","affiliation":[{"name":"MAFLD Research Centre, Department of Hepatology The First Affiliated Hospital of Wenzhou Medical University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mulong","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Centre for Global Health, School of Public Health, Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9791-8093","authenticated-orcid":false,"given":"Shanshan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Beijing Friendship Hospital, Capital Medical University; State Key Laboratory for Digestive Health; National Clinical Research Centre for Digestive Diseases  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics School of Public Health, Peking University Health Science Centre  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4325-3900","authenticated-orcid":false,"given":"Giovanni","family":"Targher","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Verona  Verona Italy"},{"name":"Metabolic Diseases Research Unit, IRCCS Sacro Cuore\u2014Don Calabria Hospital  Negrar di Valpolicella Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D.","family":"Byrne","sequence":"additional","affiliation":[{"name":"Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, and University of Southampton, Southampton General Hospital  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Centre for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. 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