Six-Month Metabolic, Inflammatory, and Elastographic Outcomes with Adjunctive Ademetionine After Coronary Artery Bypass Grafting in Patients with Metabolic Dysfunction-Associated Fatty Liver Disease

Abstract

Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) frequently coexists with advanced coronary artery disease. Coronary artery bypass grafting (CABG) may produce transient hepatic injury and systemic inflammation, while residual metabolic-inflammatory abnormalities can persist during follow-up.

Objective: To evaluate six-month metabolic, inflammatory, and liver-elastography outcomes in patients with stable exertional angina and MAFLD receiving standard post-CABG therapy with or without adjunctive ademetionine.

Methods: This comparative cohort analysis included 100 patients with stable exertional angina and MAFLD who underwent CABG for multivessel coronary artery disease. After CABG, 50 patients received standard therapy alone and 50 received standard therapy plus ademetionine (400 mg intravenously daily for 10 days, followed by 500 mg orally twice daily for 6 months). Serum adiponectin, leptin, ghrelin, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and liver elastography were evaluated. Perioperative routine laboratory changes were also summarized from the source dissertation.

Results: At six months, adjunctive ademetionine was associated with higher adiponectin (7.2 ± 0.16 vs. 4.7 ± 0.18 µg/mL; P < 0.001) and ghrelin (693.8 ± 17.5 vs. 523.9 ± 16.9 pg/mL; P < 0.001), and with lower leptin (22.2 ± 0.5 vs. 29.2 ± 0.6 ng/mL; P < 0.001), IL-6 (8.4 ± 0.4 vs. 11.1 ± 0.3 pg/mL; P < 0.001), and TNF-α (11.5 ± 0.4 vs. 15.1 ± 0.44 pg/mL; P < 0.001). Liver stiffness was lower with ademetionine (Young modulus 7.2 ± 0.1 vs. 8.86 ± 0.09 kPa; P < 0.001), as was the reported fibrosis grade (1.50 ± 0.12 vs. 1.92 ± 0.12; P < 0.05).

Conclusion: In patients with MAFLD after CABG, adjunctive ademetionine was associated with a more favorable six-month adipokine, inflammatory, and elastographic profile. Because random allocation and baseline comparability of the two treatment subgroups were not documented in the source dissertation, these findings should be interpreted as associative and require prospective randomized validation.

Keywords:

Metabolic Dysfunction-Associated Fatty Liver Disease, Coronary Artery Bypass Grafting, Ademetionine, Adiponectin, Leptin, Ghrelin, Interleukin-6, Tnf-Α, Liver Elastography

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