Lipids & metabolic liver disease
Incremental Value of Blood-Based Markers of Liver Fibrosis in Cardiovascular Risk Stratification
Authors' conclusion
In a cardiometabolically diverse population, the incremental associations of LFNITs with CVD outcomes were mediated by atherosclerotic burden rather than arterial stiffening. FIB-4 consistently demonstrated associations with all study end points. These findings provide mechanistic insights and support the clinical applicability of FIB-4 in CVD prevention.
Study context
- Population
- Individuals with or without clinically overt coronary artery disease, Athens Cardiometabolic Cohort
- Participants
- 1,692 individuals
- Exposure
- Liver fibrosis noninvasive tests (FIB-4, NAFLD Fibrosis score (NFS), BARD) vs established cardiovascular disease (CVD) risk scores for CVD risk
- Outcome
- MACE: cardiac death, acute MI or coronary revascularization
- Follow-up
- 39-month median
Methodological detailsconsecutively recruited, mediation analysis
- Consecutively recruited
- Mediation analysis
Main finding
As reported in the abstract
FIB-4 >2.67 incrementally associated with increased major adverse cardiovascular events (MACE) risk, OR
2.00 (1.12-3.55) (95% CI)
ΔAUC (95% CI) for FIB-4 >2.67
0.014
0.002–0.026
Observational data: associations, not effects.
Further findings
Markers of vascular injury (maximal wall thickness (maxWT), pulse wave velocity (PWV))
- FIB-4 the only LFNIT consistently associated with multiple markers of vascular injury, irrespective of coronary artery disease (CAD) and after adjustment (adjusted P < .05 for all)
CAD presence
- FIB-4 independently associated with CAD presence, aOR (P < .001)
- 6.55; 3.48-12.3
All-cause mortality
- Only FIB-4 (>3.25) independently and incrementally associated with all-cause mortality (adjusted P < 0.05)
Original publication
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