<h4>Background</h4>Peroxisome proliferator-activated receptor (PPAR) agonists are promising therapeutic agents for metabolic dysfunction-associated steatotic liver disease (MASLD), which increases cardiovascular risk.<h4>Methods</h4>We compared the efficacy of pemafibrate, a highly selective PPAR-α agonist, and bezafibrate, a non-selective PPAR-α agonist, in patients with coronary artery disease (CAD) and MASLD. This evidence concerns the gene PPARA and metabolic dysfunction-associated steatotic liver disease.