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Liver fibrosis scores and prognosis in patients with cardiovascular diseases: A systematic review and meta‐analysis

医学 内科学 非酒精性脂肪肝 纤维化 胃肠病学 荟萃分析 队列 队列研究 肝病 危险系数 疾病 脂肪肝 置信区间
作者
Zhiwei Yan,Yang Liu,Wei Li,Xiaopeng Zhao,Weichun Lin,Jing Zhang,Shuchun Yu,Jianyong Ma,Jingfeng Wang,Peng Yu,Weiguang Li,Xiao Liu
出处
期刊:European Journal of Clinical Investigation [Wiley]
卷期号:52 (11) 被引量:21
标识
DOI:10.1111/eci.13855
摘要

In patients with nonalcoholic fatty liver disease, liver fibrosis was associated with a higher risk of cardiovascular events. However, the relationship between liver fibrosis scores and clinical outcomes in patients with cardiovascular disease remains unclear.Searching from PubMed, EMBASE and Cochrane Library databases yielded cohort studies that reported adjusted effect size between liver fibrosis scores (Fibrosis-4 score [FIB-4] or NAFLD fibrosis score [NFS]) and prognosis in patients with cardiovascular disease. The effect size was computed using a random-effects model.This meta-analysis included twelve cohort studies involving 25,252 patients with cardiovascular disease. Participants with the highest baseline level of FIB-4 or NFS had a significantly increased risk of cardiovascular events (FIB-4, HR: 1.75, 95% CI: 1.53-2.00, I 2 = 0%; NFS, HR: 1.92, 95% CI: 1.50-2.47, I 2 = 47%). This finding was consistent with the analysis of FIB-4 or NFS as a continuous variable (per 1-unit increment FIB-4, HR: 1.15, 95% CI: 1.06-1.24, I 2 = 72%; NFS, HR: 1.15, 95% CI: 1.07-1.24, I 2 = 71%). Furthermore, participants with the highest levels of FIB-4 or NFS had a greater risk of cardiovascular mortality (FIB-4, HR: 2.07, 95% CI: 1.19-3.61, I 2 = 89%; NFS, HR: 3.72, 95% CI: 2.62-5.29, I 2 = 60%) and all-cause mortality (FIB-4, HR: 1.81, 95% CI: 1.24-2.66, I 2 = 90%; NFS, HR: 3.49, 95% CI: 2.82-4.31, I 2 = 25%). This result was also consistent as a continuous variable.Higher levels of FIB-4 and NFS are related to an increased risk of cardiovascular events, cardiovascular mortality and all-cause mortality in patients with cardiovascular disease.
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