Association between liver fibrosis scores and the risk of mortality among patients with coronary artery disease

Chen, Qian; Li, Dan; Chen, Xuechen; Liu, Zhaomin; Hu, Gang; Wang, Jingfeng; Liu, Wenhua

doi:10.1016/j.atherosclerosis.2020.03.010

Cited by 50 publications

(87 citation statements)

References 42 publications

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“…NFS was rst used as a marker of advanced brosis in patients with NAFLD [18]. However, it was then found to be associated with CVD risk factors in different populations, regardless of the presence of NAFLD or not [8,19]. Consistently, we also observed positive associations of NFS with age, BMI, LDL-C and HbA1c.…”

Section: Discussionsupporting

confidence: 79%

“…Second, diagnosis of NAFLD was not included in the present study, precluding further analysis by stratifying the presence of NAFLD. However, NFS was previously shown to be associated with CVD and mortality in different population, regardless of the presence of NAFLD or not [8,15]. Third, liver biopsy was not taken in the evaluation of brosis.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with NAFLD have a higher prevalence of CVD and are more likely to die from CVD than from liver-related death [4][5][6]. Among the categories of NAFLD, liver brosis is considered as the main indicator of prognosis in NAFLD and was found to be independently associated with CVD and motality in different populations [6][7][8]. However, the relationship between liver brosis and CVD in type 2 diabetic patients, who have a high prevalence of NAFLD, is limitedly investigated [9,10].…”

Section: Introductionmentioning

confidence: 99%

“…Evidence has indicated that NFS is associated with coronary atherosclerosis and predicts cardiovascular events and mortality in subjects with NAFLD [12][13][14]. Further study revealed that NFS was also associated with cardiovascular mortality in different populations, including patients with heart failure or coronary artery disease and even in the general population, regardless of the presence of NAFLD [8,[13][14][15][16]. However, the relationship between NFS and CVD in type 2 diabetic subjects was rarely studied [10,17].…”

Section: Introductionmentioning

confidence: 99%

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Association of NAFLD Fibrosis Score with Subclinical Myocardial Remodeling in Patients with Type 2 Diabetes: A Cross-Sectional Study in China

Fan

Ding

et al. 2020

Preprint

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Background: Nonalcoholic fatty liver disease (NAFLD), especially with liver fibrosis, is associated with cardiovascular diseases (CVD). NAFLD fibrosis score (NFS), a noninvasive marker of advanced fibrosis first developed in patients with NAFLD, has found to be associated with CVD in different populations including with diabetes, regardless of the presence of NAFLD. The aim of the present study was to determine whether NFS is associated with subclinical myocardial remodeling in type 2 diabetic patients.Methods: A cross-sectional study was performed in type 2 diabetic patients. NFS derived from available parameters was calculated and the subjects were divided into four groups according to the quartiles of NFS. Subclinical myocardial remodeling was examined by echocardiography and its association with NFS was analyzed.Results: A total of 1878 type 2 diabetic patients were enrolled in the present study. Subjects with higher NFS were older, had a longer duration of diabetes and higher levels of body mass index (BMI), systolic blood pressure (SBP) and serum creatinine (Scr) than those with lower NFS (P < 0.01). Multiple linear regression analysis revealed that sex, age, BMI, LDL-C and HbA1c were independent determiners of NFS in type 2 diabetic patients. Parameters of subclinical myocardial remodeling including left atrial dimension (LAD), interventricular septum thickness (IST), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular posterior wall thickness (LVPWT) were all gradually increased with the increment of NFS. Linear regression analysis further revealed that NFS was positively associated with LAD, IST, LVEDD, LVESD and LVPWT after adjustment for the confounding factors.Conclusions: NFS is independently associated with subclinical myocardial remodeling in type 2 diabetic subjects.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Association of NAFLD Fibrosis Score with Subclinical Myocardial Remodeling in Patients with Type 2 Diabetes: A Cross-Sectional Study in China

Fan

Ding

et al. 2020

Preprint

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“…However, no study for investigating the association between sub-clinical hepatic brosis and the outcomes of sepsis was performed before. Several non-invasive brosis scoring systems, such as aspartate aminotransferase-platelet ratio index (APRI), brosis-4 (FIB-4) score and non-alcoholic fatty liver disease brosis score (NFS) [16,17,18], were widely used to evaluate the risk of poor prognosis in chronic liver diseases [19,20], cardiovascular and cerebrovascular diseases [21,22], and malignant tumors [23,24]. Therefore, the purpose of our study is to explore the potential association of liver brosis indexes with the outcomes of septic patients without overt chronic liver disease.…”

Section: Introductionmentioning

confidence: 99%

Elevated liver fibrosis index FIB-4 is associated with poor clinical outcomes in patients with sepsis, an observational cohort study

Zhu

Qin

Pan

et al. 2020

Preprint

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Background: No study for investigating the association between sub-clinical hepatic fibrosis and the outcomes of sepsis was performed before. Therefore, the purpose is to explore the association of liver fibrosis indexes with the outcomes of septic patients without overt chronic liver disease. Methods: We performed a cohort study using data extracted from the Medical Information Mart for Intensive Care Ⅲ database (v1.4). The patient records of additional external validation were obtained from the First Affiliated Hospital of Wenzhou Medical University. Aspartate aminotransferase-platelet ratio index (APRI), fibrosis-4 (FIB-4) score and non-alcoholic fatty liver disease fibrosis score (NFS) were calculated with previous formulas. The primary outcome was 28-day mortality. The secondary outcomes were 90-day mortality, in-hospital mortality and renal replacement therapy (RRT). We assessed the associations of three indexes with primary and secondary outcomes using logistic regression analysis. Furthermore, we performed multivariable analysis, sensitivity analysis and additional external validation to verify the true strength of the results.Results: In the FIB-4-sepsis cohort (N = 1560), there was a statistically significant stepwise increase from Quartile 1 to Quartile 4 in the risk of 28-day mortality (Quartile 1: reference; Quartile 2: OR = 1.570, P = 0.061, 95%CI = 0.980–2.515; Quartile 3: OR = 2.363, P < 0.001, 95%CI = 1.512–3.692; Quartile 4: OR = 2.933, P < 0.001, 95%CI = 1.895–4.538). Similarly, the increased trends could also be found in all secondary outcomes for the FIB-4-sepsis cohort. However, no significant trends were observed in the APRI-sepsis and NFS-sepsis cohorts. The results of multivariable logistic regression analysis, Kaplan-Meier analysis, Cox regression analysis and additional external validation showed good consistency.Conclusions: FIB-4 index was associated with 28-day mortality, 90-day mortality, in-hospital mortality and RRT in the septic patients without overt chronic liver disease. In other words, the high stage of sub-clinical hepatic fibrosis represented by FIB-4 could reflect the poor outcomes of patients with sepsis.

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Association of liver fibrosis‐4 index with adverse outcomes in hypertrophic cardiomyopathy patients

Abdu,

Mareai,

Xiang

et al. 2024

ESC Heart Failure

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AimsThe fibrosis‐4 index (FIB‐4) is a non‐invasive tool to assess fibrosis risk in chronic liver disease. We aimed to explore the relationship between the FIB‐4 index and long‐term major adverse cardiovascular events (MACE) in HCM patients.Methods and resultsConsecutive patients diagnosed with HCM were included. Patients were divided into two groups using a defined cutoff value established through a ROC analysis for predicting MACE (FIB‐4 ≥ 2.37 and FIB‐4 < 2.37). The final analysis comprised 187 HCM patients (34.8% females, 66.49 ± 11.43 years of age), with 47 (25.1%) in the FIB‐4 ≥ 2.37 group and 140 (74.9%) in the FIB‐4 < 2.37 group. Among these, 147 (78.6%) individuals had complete follow‐up data. Patients with FIB‐4 ≥ 2.37 demonstrated a higher prevalence of co‐morbidities such as atrial fibrillation (27.7% vs. 7.9%; P < 0.001), heart failure (55.3% vs. 24.3%; P < 0.001), elevated NT‐proBNP levels (3.03 ± 4.74 vs. 0.66 ± 1.08; P < 0.001), and lower LVEF (58.51 ± 7.86 vs. 61.84 ± 5.04; P = 0.001). Over a median of 41 (IQR 16–63) months follow‐up, MACE occurred in 49 (33.3%), with a significantly higher incidence in the FIB‐4 ≥ 2.37 group (58.8% vs. 25.7%, P < 0.001). Cardiac death rates were also elevated in the FIB‐4 ≥ 2.37 group (20.6% vs. 2.7%, P = 0.001). Cox regression analysis revealed an independent association between FIB‐4 ≥ 2.37 and a higher risk of MACE (adjusted HR: 1.919, 95% CI 1.015–3.630; P = 0.045) and cardiac death (adjusted HR: 9.518, 95% CI 1.718–52.732; P = 0.010). Furthermore, the FIB‐4 index shows positive correlations with left atrium diameter (r = 0.229; P = 0.003), septal thickness (r = 0.231; P = 0.002), posterior wall thickness (r = 0.235; P = 0.001), and NT‐proBNP (r = 0.271; P < 0.001). Conversely, a negative correlation was observed between the FIB‐4 index and left ventricular ejection fraction (r = −0.185; P = 0.011).ConclusionElevated FIB‐4 index, indicative of liver fibrosis, is independently associated with an increased risk of long‐term MACE in HCM patients. This emphasizes the potential influence of liver function abnormalities on HCM prognosis, underscoring the need for comprehensive risk assessment in clinical management.

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Association between liver fibrosis scores and the risk of mortality among patients with coronary artery disease

Cited by 50 publications

References 42 publications

Association of NAFLD Fibrosis Score with Subclinical Myocardial Remodeling in Patients with Type 2 Diabetes: A Cross-Sectional Study in China

Association of NAFLD Fibrosis Score with Subclinical Myocardial Remodeling in Patients with Type 2 Diabetes: A Cross-Sectional Study in China

Elevated liver fibrosis index FIB-4 is associated with poor clinical outcomes in patients with sepsis, an observational cohort study

Association of liver fibrosis‐4 index with adverse outcomes in hypertrophic cardiomyopathy patients

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