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RecruitingNCT07865936MASLD-CACUpdated Oct 8, 2026

Cardiovascular Risk Assessment and Coronary Calcium Score in Thai MASLD Patients

An observational study in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), Cardiovascular Disease (CVD) and Coronary Artery Calcification, sponsored by Watcharasak Chotiyaputta. Recruiting at 1 site in Thailand. Open to participants aged 35 Years to 75 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-10-08.

Sponsored by Watcharasak Chotiyaputta · Observational

From the registry’s dates

  • Started Jun 2026; still recruiting 3 months later.
Updated Oct 8, 2026Newly registeredGo to Updates ↓
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
251
Ages
35 Years to 75 Years
Sex
All
01

Study summary

Metabolic dysfunction-associated steatotic liver disease (MASLD) is common in Thailand and is strongly linked to metabolic risk factors such as obesity, diabetes, hypertension, and dyslipidemia. Cardiovascular disease is the leading cause of death among patients with MASLD. Coronary artery calcium (CAC) scoring is a widely used marker of subclinical coronary atherosclerosis. This study aims to evaluate the association between cardiovascular risk assessment tools and CAC scores in Thai patients with MASLD to improve cardiovascular risk stratification in this population.

Read the detailed description

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major public health concern in Thailand, with a high prevalence among individuals undergoing health evaluations. MASLD is closely associated with metabolic abnormalities and is recognized as an independent risk factor for cardiovascular disease (CVD). Although MASLD primarily affects the liver, multiple studies have shown that CVD is the leading cause of mortality in this population. Contributing mechanisms include insulin resistance, chronic low-grade inflammation, oxidative stress, and atherogenic dyslipidemia.

Coronary artery calcium (CAC) scoring, obtained through non-contrast cardiac CT, is a validated tool for detecting subclinical coronary atherosclerosis and predicting future cardiovascular events. Commonly used cardiovascular risk calculators-such as the Framingham Risk Score, ASCVD Risk Estimator, and UKPDS risk engine-were developed in Western populations and may not accurately reflect cardiovascular risk in Asian or Thai patients.

This observational study aims to investigate the relationship between cardiovascular risk assessment tools and CAC scores in Thai patients diagnosed with MASLD. Clinical data, metabolic parameters, liver disease severity, and CAC scores will be analyzed to determine how well existing risk calculators correlate with coronary calcification in this population. The findings may support improved cardiovascular risk stratification and help identify MASLD patients who may benefit from early cardiovascular evaluation.

02

Conditions studied

  • Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)
  • Cardiovascular Disease (CVD)
  • Coronary Artery Calcification

Keywords

  • MASLD
  • Metabolic Dysfunction-Associated Steatotic Liver Disease
  • Coronary Artery Calcium (CAC)
  • Liver Disease and Cardiovascular Risk
03

In context

Cardiovascular Diseases

4,904 studies on the registry are indexed under Cardiovascular Diseases; 919 are open to participants now.

This study's planned enrollment of 251 is below the median of 573 across 1,485 observational studies indexed under Cardiovascular Diseases.

Browse Cardiovascular Diseases studies →

Lead sponsor

This is the only study on the registry with Watcharasak Chotiyaputta as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
35 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

Thai adults aged 35-75 years diagnosed with MASLD who underwent coronary artery calcium scoring at Siriraj Hospital. Clinical, metabolic, liver disease severity, and CAC score data are collected for cardiovascular risk analysis.

Inclusion criteria

  • Asymptomatic
  • Diagnosed MASLD by: Ultrasound showing fatty liver, or FibroScan CAP ≥ 248 dB/m
  • Available liver fibrosis assessment (FIB-4, APRI)
  • Complete clinical and laboratory data required for cardiovascular risk assessment

Exclusion criteria

Exclusion Criteria:

  • History of myocardial infarction, PCI, or CABG
  • History of stroke or peripheral arterial disease
  • History of heart failure, RV dysfunction, or pulmonary hypertension
  • Chronic hepatitis B or C
  • Autoimmune hepatitis, Wilson's disease, hemochromatosis
  • Alcohol intake >30 g/day (men) or >20 g/day (women)
  • CKD stage 4-5 or ESRD
  • Advanced cancer
  • Pregnancy
05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
251 participants (estimated)
Target follow-up
10 Years
Patient registry
Yes

Groups and cohorts

  • MASLD Cohort

    Thai adult patients diagnosed with metabolic dysfunction-associated steatotic liver disease (MASLD) who underwent coronary artery calcium (CAC) scoring at Siriraj Hospital. Clinical, metabolic, liver disease severity, and CAC score data are collected to evaluate the association between cardiovascular risk assessment tools and coronary calcification.

06

What researchers measure

Primary outcomes

  1. Association between Thai CV Risk Score and Coronary Artery Calcium (CAC) Score in Thai MASLD patients

    The study will evaluate the correlation between the Thai CV risk score and the coronary artery calcium (CAC) score in Thai patients diagnosed with MASLD. Clinical and metabolic parameters will be used to calculate ASCVD risk, and CAC scores will be obtained from non-contrast cardiac CT.

    Time frame: Baseline

07

Study locations

1 of 1 sites recruiting
  • Faculty of Medicine Siriraj Hospital, Mahidol University
    Bangkok, Bangkoknoi 10700, Thailand
    Recruiting
08

References and documents

Publications

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  • Gershon GS, Barr JR, Razavi AC, Yang Y, Momin E, Dzaye O, Whelton SP, Blaha MJ, Blumenthal RS, Sperling LS, De Cecco CN, van Assen M. Coronary artery calcium burden across the pooled cohort equation versus the American Heart Association PREVENT risk calculator. Am J Prev Cardiol. 2025 Sep 17;24:101301. doi: 10.1016/j.ajpc.2025.101301. eCollection 2025 Dec. PubMed 41078705 ↗
  • Neves PO, Andrade J, Moncao H. Coronary artery calcium score: current status. Radiol Bras. 2017 May-Jun;50(3):182-189. doi: 10.1590/0100-3984.2015.0235. PubMed 28670030 ↗
  • Ma G, Xu G, Huang H. Correlation between metabolic dysfunction-associated steatotic liver disease and subclinical coronary atherosclerosis in eastern China. Diabetol Metab Syndr. 2025 Jan 16;17(1):16. doi: 10.1186/s13098-025-01577-z. PubMed 39815332 ↗
  • Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, Chapman MJ, De Backer GG, Delgado V, Ference BA, Graham IM, Halliday A, Landmesser U, Mihaylova B, Pedersen TR, Riccardi G, Richter DJ, Sabatine MS, Taskinen MR, Tokgozoglu L, Wiklund O; ESC Scientific Document Group. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020 Jan 1;41(1):111-188. doi: 10.1093/eurheartj/ehz455. No abstract available. PubMed 31504418 ↗
  • Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, Himmelfarb CD, Khera A, Lloyd-Jones D, McEvoy JW, Michos ED, Miedema MD, Munoz D, Smith SC Jr, Virani SS, Williams KA Sr, Yeboah J, Ziaeian B. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019 Sep 10;140(11):e563-e595. doi: 10.1161/CIR.0000000000000677. Epub 2019 Mar 17. PubMed 30879339 ↗
  • Tiansuwan N, Sasiprapha T, Jongjirasiri S, Unwanatham N, Thakkinstian A, Laothamatas J, Limpijankit T. Utility of coronary artery calcium in refining 10-year ASCVD risk prediction using a Thai CV risk score. Front Cardiovasc Med. 2023 Nov 2;10:1264640. doi: 10.3389/fcvm.2023.1264640. eCollection 2023. PubMed 38028497 ↗
  • 22. UKPDS Cardiac Risk Calculator. Available from: https://www.mdapp.co/ukpds-cardiac-risk-calculator-215/.
  • 21. ASCVD Risk Estimator Plus. Available from: https://tools.acc.org/ascvd-risk-estimator-plus/#!/calculate/estimate/.
  • 20. FHS Cardiovascular Disease (10-year risk). Available from: https://www.framinghamheartstudy.org/fhs-risk-functions/cardiovascular-disease-10-year-risk/.
  • 19. Thai CV risk score. Available from: https://www.rama.mahidol.ac.th/cardio_vascular_risk/thai_cv_risk_score/.
  • Kavaric N, Klisic A, Ninic A. Cardiovascular Risk Estimated by UKPDS Risk Engine Algorithm in Diabetes. Open Med (Wars). 2018 Dec 31;13:610-617. doi: 10.1515/med-2018-0086. eCollection 2018. PubMed 30847393 ↗
  • Karlas T, Petroff D, Sasso M, Fan JG, Mi YQ, de Ledinghen V, Kumar M, Lupsor-Platon M, Han KH, Cardoso AC, Ferraioli G, Chan WK, Wong VW, Myers RP, Chayama K, Friedrich-Rust M, Beaugrand M, Shen F, Hiriart JB, Sarin SK, Badea R, Jung KS, Marcellin P, Filice C, Mahadeva S, Wong GL, Crotty P, Masaki K, Bojunga J, Bedossa P, Keim V, Wiegand J. Individual patient data meta-analysis of controlled attenuation parameter (CAP) technology for assessing steatosis. J Hepatol. 2017 May;66(5):1022-1030. doi: 10.1016/j.jhep.2016.12.022. Epub 2016 Dec 28. PubMed 28039099 ↗
  • Rinella ME, Lazarus JV, Ratziu V, Francque SM, Sanyal AJ, Kanwal F, Romero D, Abdelmalek MF, Anstee QM, Arab JP, Arrese M, Bataller R, Beuers U, Boursier J, Bugianesi E, Byrne CD, Castro Narro GE, Chowdhury A, Cortez-Pinto H, Cryer DR, Cusi K, El-Kassas M, Klein S, Eskridge W, Fan J, Gawrieh S, Guy CD, Harrison SA, Kim SU, Koot BG, Korenjak M, Kowdley KV, Lacaille F, Loomba R, Mitchell-Thain R, Morgan TR, Powell EE, Roden M, Romero-Gomez M, Silva M, Singh SP, Sookoian SC, Spearman CW, Tiniakos D, Valenti L, Vos MB, Wong VW, Xanthakos S, Yilmaz Y, Younossi Z, Hobbs A, Villota-Rivas M, Newsome PN; NAFLD Nomenclature consensus group. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol. 2023 Dec;79(6):1542-1556. doi: 10.1016/j.jhep.2023.06.003. Epub 2023 Jun 24. PubMed 37364790 ↗
  • Kalaiyarasi K, Sanchalika A, Hsien Min L, Wei Ming Y, Vishalkumar S, Kuo Chao Y, Jee Keem L, Sameer J, Terence HCW, Yen Ping T. Transient Elastography Is the Best-Performing Non-Invasive Test of Liver Fibrosis in Obese Asian Patients with Non-Alcoholic Fatty Liver Disease: A Pilot, Cross-Sectional Study. Medicina (Kaunas). 2024 Jan 17;60(1):169. doi: 10.3390/medicina60010169. PubMed 38256429 ↗
  • Koulaouzidis G, Charisopoulou D, Kukla M, Marlicz W, Rydzewska G, Koulaouzidis A, Skonieczna-Zydecka K. Association of non-alcoholic fatty liver disease with coronary artery calcification progression: a systematic review and meta-analysis. Prz Gastroenterol. 2021;16(3):196-206. doi: 10.5114/pg.2021.109063. Epub 2021 Sep 17. PubMed 34584580 ↗
  • Lee YJ, Shim JY, Moon BS, Shin YH, Jung DH, Lee JH, Lee HR. The relationship between arterial stiffness and nonalcoholic fatty liver disease. Dig Dis Sci. 2012 Jan;57(1):196-203. doi: 10.1007/s10620-011-1819-3. Epub 2011 Jul 13. PubMed 21750929 ↗
  • Lolekha P, Khovidhunkit W, Deerochanawong C, Thongtang N, Boonyasirinant T, Rattarasarn C, Chutinet A, Ophascharoensuk V, Somlaw N, Sitthisook S, Suntorntham S, Nitiyanant W, Krittayaphong R. 2024 The Royal College of Physicians of Thailand (RCPT) clinical practice guidelines on management of dyslipidemia for atherosclerotic cardiovascular disease prevention. Asian Biomed (Res Rev News). 2024 Dec 16;18(6):246-267. doi: 10.2478/abm-2024-0033. eCollection 2024 Dec. PubMed 39697215 ↗
  • Sritara P, Cheepudomwit S, Chapman N, Woodward M, Kositchaiwat C, Tunlayadechanont S, Sura T, Hengprasith B, Tanphaichitr V, Lochaya S, Neal B, Tanomsup S, Yipintsoi T; Electricity Generating Authority of Thailand. Twelve-year changes in vascular risk factors and their associations with mortality in a cohort of 3499 Thais: the Electricity Generating Authority of Thailand Study. Int J Epidemiol. 2003 Jun;32(3):461-8. doi: 10.1093/ije/dyg105. PubMed 12777437 ↗
  • Chia YC, Gray SY, Ching SM, Lim HM, Chinna K. Validation of the Framingham general cardiovascular risk score in a multiethnic Asian population: a retrospective cohort study. BMJ Open. 2015 May 19;5(5):e007324. doi: 10.1136/bmjopen-2014-007324. PubMed 25991451 ↗
  • Christianson TJ, Bryant SC, Weymiller AJ, Smith SA, Montori VM. A pen-and-paper coronary risk estimator for office use with patients with type 2 diabetes. Mayo Clin Proc. 2006 May;81(5):632-6. doi: 10.4065/81.5.632. PubMed 16706261 ↗
  • Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, Himmelfarb CD, Khera A, Lloyd-Jones D, McEvoy JW, Michos ED, Miedema MD, Munoz D, Smith SC Jr, Virani SS, Williams KA Sr, Yeboah J, Ziaeian B. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019 Sep 10;140(11):e596-e646. doi: 10.1161/CIR.0000000000000678. Epub 2019 Mar 17. No abstract available. PubMed 30879355 ↗
  • D'Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008 Feb 12;117(6):743-53. doi: 10.1161/CIRCULATIONAHA.107.699579. Epub 2008 Jan 22. PubMed 18212285 ↗
  • De Filippo O, Di Pietro G, Nebiolo M, Ribaldone DG, Gatti M, Bruno F, Gallone G, Armandi A, Birtolo LI, Zullino V, Mennini G, Corradini SG, Mancone M, Bugianesi E, Iannaccone M, De Ferrari GM, D'Ascenzo F. Increased prevalence of high-risk coronary plaques in metabolic dysfunction associated steatotic liver disease patients: A meta-analysis. Eur J Clin Invest. 2024 Sep;54(9):e14188. doi: 10.1111/eci.14188. Epub 2024 Feb 23. PubMed 38396359 ↗
  • Sharma A, Pagidipati NJ, Califf RM, McGuire DK, Green JB, Demets D, George JT, Gerstein HC, Hobbs T, Holman RR, Lawson FC, Leiter LA, Pfeffer MA, Reusch J, Riesmeyer JS, Roe MT, Rosenberg Y, Temple R, Wiviott S, McMurray J, Granger C. Impact of Regulatory Guidance on Evaluating Cardiovascular Risk of New Glucose-Lowering Therapies to Treat Type 2 Diabetes Mellitus: Lessons Learned and Future Directions. Circulation. 2020 Mar 10;141(10):843-862. doi: 10.1161/CIRCULATIONAHA.119.041022. Epub 2020 Jan 29. PubMed 31992065 ↗
  • Simon TG, Roelstraete B, Hagstrom H, Sundstrom J, Ludvigsson JF. Non-alcoholic fatty liver disease and incident major adverse cardiovascular events: results from a nationwide histology cohort. Gut. 2022 Sep;71(9):1867-1875. doi: 10.1136/gutjnl-2021-325724. Epub 2021 Sep 6. PubMed 34489307 ↗
  • Michalopoulou E, Thymis J, Lampsas S, Pavlidis G, Katogiannis K, Vlachomitros D, Katsanaki E, Kostelli G, Pililis S, Pliouta L, Kountouri A, Papanikolaou IS, Lambadiari V, Ikonomidis I. The Triad of Risk: Linking MASLD, Cardiovascular Disease and Type 2 Diabetes; From Pathophysiology to Treatment. J Clin Med. 2025 Jan 10;14(2):428. doi: 10.3390/jcm14020428. PubMed 39860434 ↗
  • Platek AE, Szymanska A. Metabolic dysfunction-associated steatotic liver disease as a cardiovascular risk factor. Clin Exp Hepatol. 2023 Sep;9(3):187-192. doi: 10.5114/ceh.2023.130744. Epub 2023 Aug 28. PubMed 37790680 ↗
  • Sono S, Kaewdech A, Wongsawanon C, Varanuntakul T, Jarupanich T, Sritanabutr N, Ruangtanthawat P, Phanukasemsin M, Inchan L, Chamroonkul N, Sripongpun P. Metabolic dysfunction-associated fatty liver disease (MAFLD) in the adult population attending a health check-up program in Thailand: prevalence and fibrosis status. Sci Rep. 2025 Jul 1;15(1):21429. doi: 10.1038/s41598-025-06874-1. PubMed 40596357 ↗

Individual participant data

Plan to share: No — Individual participant data will not be shared due to patient privacy protection and institutional policy regarding clinical data from Siriraj Hospital.

09

Updates

1 registry update since Sep 25, 2026
Registered
First appeared on the registry. No changes since
Oct 8, 2026
Show all 1 update
  1. Oct 8, 2026
    First appeared on the registry

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07865936
Lead sponsor
Watcharasak Chotiyaputta
Responsible party
Watcharasak Chotiyaputta (Assoc. Prof. Watcharasak Chotiyaputta, M.D., Mahidol University) — Sponsor-investigator
First posted
Oct 8, 2026
Start date
Jun 24, 2026
Primary completion
May 23, 2027 (estimated)
Completion
Jun 23, 2036 (estimated)
Last update
Oct 8, 2026

Study contacts

Assoc. Prof. Watcharasak Chotiyaputta, M.D.
Contact
watcharasak.cho@mahidol.ac.th
+66 85-125-5489
Thammarin Khaoropphan, M.D.
study director · Siriraj Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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