Fibrosis tool also warns of CVD risk

Liver fibrosis, as determined by the fibrosis-4 (FIB-4) score, is an independent risk factor for cardiovascular disease (CVD) in healthy people, a recent study has shown.

The study included a historical cohort consisting of 8,511 individuals, of whom 3,292 had inconclusive fibrosis and 195 had advanced fibrosis (FIB-4 score ≥2.67). Participants were drawn from a centralized computerized personal medical record repository, which was monitored for the occurrence of a fatal or nonfatal myocardial infarction (MI) or a stroke event.

Over an average follow-up duration of 3,143±992.17 days, a total of 1,786 CVD events occurred, yielding an incidence rate of 20.98 percent. There was a total of 424 and 737 stroke and ischaemic heart disease episodes. A total of 913 patients died, with a mortality rate of 10.73 percent.

Kaplan-Meier curves showed that CVD survival rates were significantly lowered among participants with inconclusive fibrosis, and even more so in those with advanced fibrosis.

Cox regression analysis, fully adjusted for confounders such as aspirin and statin use and other comorbidities, confirmed that advanced fibrosis was a significant predictor for the occurrence of CVD events (hazard ratio [HR], 1.63, 95 percent confidence interval [CI], 1.29–2.06). Inconclusive fibrosis achieved borderline significance (HR, 1.08, 95 percent CI, 0.97–1.19).

“FIB-4 is simple to use at point-of-care by using web-based calculators or by implementation into computerized medical records. In addition, FIB-4 incurs minimal costs since it is based on widely available routine blood tests,” the researcher said.

“Such an approach may also be used in the future for CVD risk stratification and to promote early implementation of prevention measures within the primary care setting,” they added.