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Liver fibrosis scores and coronary atherosclerosis: novel findings in patients with stable coronary artery disease

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Abstract

Background

Although non-invasive liver fibrosis scores (LFSs) have already been considered as effective tools for estimating cardiovascular risk, their roles in predicting disease severity and cardiovascular event (CVEs) in patients with stable coronary artery disease (CAD) are not comprehensively evaluated. The aim of the present study was to investigate whether non-alcoholic fatty liver disease fibrosis score (NAFLD-FS) and fibrosis-4 (FIB-4) are associated with CVEs in a large cohort with long-term follow-up.

Methods

A cohort of 5143 patients with angiography-proven stable CAD were consecutively enrolled and followed up for CVEs. The degree of coronary severity was assessed using the number of diseased vessels, Gensini, Syntax, and Jeopardy scores. The predictive values of NAFLD-FS and FIB-4 scores to coronary severity, coronary calcification (CAC), and CVEs were assessed, respectively.

Results

During a median follow-up of 7 years, 435 CVEs were recorded. Both NAFLD-FS and FIB-4 were predictors for the presence of CAC. The degree of coronary stenosis was significantly higher in high NAFLD-FS categories while FIB-4 was only positively associated with the number of diseased vessels and Gensini score. In Kaplan–Meier analysis, the patients with intermediate and high NAFLD-FS and FIB-4 had higher risk of CVEs and cardiovascular mortality. In multivariate Cox regression analysis, NAFLD-FS and FIB-4 were independently associated with CVEs [hazard ratio (95% confidence interval): 1.150 (1.063–1.244), p < 0.001 and 1.128 (1.026–1.240), p = 0.012].

Conclusion

The current data first indicated that both NAFLD-FS and FIB-4 scores were not only significantly related to coronary severity but also associated with CAC and CVEs.

Clinical trials registration

None.

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Data availability

The datasets used and/or analysed during the current study are not publicly available but are available from the corresponding author on reasonable request.

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Funding

This work was partially supported by the Capital Health Development Fund (201614035) and CAMS Major Collaborative Innovation Project (2016-I2M-1-011) awarded to Dr. Jian-Jun Li, MD, PhD. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Additionally, the authors thank all the staff and participants of this study for their important contributions.

Author information

Authors and Affiliations

  1. State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fu Wai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China

    Jing-Lu Jin, Hui-Wen Zhang, Ye-Xuan Cao, Hui-Hui Liu, Yan Zhang, Yuan-Lin Guo, Na-Qiong Wu, Cheng-Gang Zhu, Rui-Xia Xu, Ying Gao, Chuan-Jue Cui, Geng Liu, Jing Sun, Qian Dong & Jian-Jun Li

  2. Department of Endocrinology, Genetics and Metabolism, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, 100045, China

    Jing-Lu Jin

  3. Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China

    Qi Hua

  4. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China

    Yan-Fang Li

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  1. Jing-Lu Jin
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  2. Hui-Wen Zhang
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Contributions

JJL contributed to the conception and design of the work. All contributed to the acquisition, analysis, or interpretation of data for the work. JLJ drafted the manuscript. JJL critically revised the manuscript.

Corresponding author

Correspondence to Jian-Jun Li.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (FuWai Hospital and National Center for Cardiovascular Diseases, Beijing, China) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent to participate was obtained from all individual participants included in the study. Informed consent to publish was obtained from all individual participants included in the study.

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Jin, JL., Zhang, HW., Cao, YX. et al. Liver fibrosis scores and coronary atherosclerosis: novel findings in patients with stable coronary artery disease. Hepatol Int 15, 413–423 (2021). https://doi.org/10.1007/s12072-021-10167-w

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  • DOI: https://doi.org/10.1007/s12072-021-10167-w

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