Predictive value of liver fibrosis scores in cardiovascular diseases among hypertensive population

Abstract

Purpose: To explore the predictive value of liver fibrosis scores [fibrosis-4, AST/platelet ratio index, BAAT score (BMI Age ALT TG), and BARD score (BMI AST/ALT Ratio Diabetes)] for the risk of cardiovascular disease (CVD) in a hypertensive population. Methods: A total of 4164 hypertensive participants without history of CVD were enrolled in the follow-up. Four liver fibrosis scores (LFSs) were used, including the fibrosis-4 (FIB-4), APRI, BAAT score, and BARD score. The endpoint was CVD incidence which was defined as stroke or coronary heart disease (CHD) during the follow-up period. Cox regression analyses were used to calculate hazard ratios between LFSs and CVD. Kaplan–Meier curve was used to show the probability of CVD in different levels of LFSs. Restricted cubic spline further explored whether the relationship between LFSs and CVD was linear. Finally, we assessed the discriminatory ability of each LFS for CVD was assessed using C -statistics, net reclassification index (NRI), and integrated discrimination improvement (IDI). Results: During a median follow-up time of 4.66 years, 282 hypertensive participants had CVD. Kaplan–Meier curve showed that four LFSs were associated with CVD and high levels of LFSs significantly increase the probability of CVD in hypertensive population. In the multivariate Cox regression analysis, the adjusted hazard ratios for four LFSs were 3.13 in FIB-4, 1.66 in APRI, 1.47 in BAAT score, and 1.36 in BARD score. Moreover, after adding LFSs to original risk prediction model, we find that all four new models have higher C -statistics of CVD than the traditional model. Furthermore, the results of both NRI and IDI were positive, indicating that LFSs enhanced the effect on the prediction of CVD. Conclusions: Our study showed that LFSs were associated with CVD in hypertensive populations in northeastern China. Furthermore, it suggested that LFSs could be a new tool for identifying patients at high risk of primary CVD in a hypertensive population.

Liver Fibrosis Scores as Predictors of Blood-Culture-Positive and Sepsis in Patients with Klebsiella pneumoniae Liver Abscess

“… 21 Xiong et al suggested that the liver fibrosis score (FIB-4 and APRI) could predict the risk of cardiovascular disease (CVD) in a hypertensive population. 22 …”

Investigating the Association between Coronary Artery Disease and the Liver Fibrosis-4 Index in Patients Who Underwent Coronary Computed Tomography Angiography: A Cross-Sectional Study

“…FIB-4I can potentially predict the future cardiovascular events in patients with HTN [30]. When using a low FIB-4I value as the reference, the instances of cardiovascular events was reported to be significantly higher in medium and high categories (HRs = 1.88 and 2.98, respectively).…”

Association between Major Adverse Cardiovascular Events and the Liver Fibrosis Score in Patients with and without Coronary Artery Disease: From the FU-CCTA Registry

“…HTN is one of the most important coronary risk factors [ 21 , 25 ] and is closely associated with the development of MACEs. Xiong et al reported that the liver fibrosis score was associated with cardiovascular disease in hypertensive populations in northeastern China [ 26 ]. The prevention of MACEs and further strengthening risk stratification for hypertensives are very important.…”