Aspirin for Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease

Inclusion Criteria: 1. 18 years of age or older 2. Diagnosed with MASLD, which is defined by the Delphi consensus, with at least one out of five cardiometabolic criteria Exclusion Criteria: 1. Increased alcohol intake (average ≥ 20 g/day for women and ≥ 30 g/day for men) 2. Glycated hemoglobin (HbA1c) level ≥ 9.0% 3. Other causes of chronic liver disease, such as HBV, HCV, autoimmune hepatitis, Wilson's disease, etc. 4. Liver decompensation (Child-Pugh class B or C) 5. Liver cirrhosis with significant portal hypertension (platelet count \< 100,000/mm3, splenomegaly, and/or the presence of esophageal/gastric varices) 6. High-risk EGV, defined as F2, F3, or with red-color signs, diagnosed by endoscopy within 6 months before screening 7. Active peptic ulcer disease diagnosed by endoscopy within 6 months be- fore screening 8. FIB-4 index \< 1.3 at screening 9. Indicated for any anti-platelet therapy, such as history of cardiovascular events 10. History of aspirin allergy 11. History of bleeding disorders, such as hemophilia 12. Pregnancy or breast feeding 13. Severe renal impairment, which is defined as eGFR \< 30 mL/min/1.73 m² 14. Any malignancies