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Association between liver fibrosis scores and the risk of mortality among patients with coronary artery disease

  • Qian Chen
    Affiliations
    Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China
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  • Qing Li
    Affiliations
    Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China

    Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, Guangdong, 510080, China
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  • Dan Li
    Affiliations
    Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China

    Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, Guangdong, 510080, China

    Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou, Guangdong, 510080, China
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  • Xuechen Chen
    Affiliations
    Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China

    Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, Guangdong, 510080, China
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  • Zhaomin Liu
    Affiliations
    Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China

    Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, Guangdong, 510080, China

    Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou, Guangdong, 510080, China
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  • Gang Hu
    Affiliations
    Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, 70808, United States
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  • Jingfeng Wang
    Correspondence
    Corresponding author. Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No.107 Yanjiang Xi Road, Guangzhou, Guangdong, 510120, China.
    Affiliations
    Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510120, China
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  • Wenhua Ling
    Correspondence
    Corresponding author. Department of Nutrition, School of Public Health, Sun Yat-sen University & Guangdong Provincial Key Laboratory of Food, Nutrition and Health, No.74 Zhongshan Road 2, Guangzhou, Guangdong, 510080, China.
    Affiliations
    Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China

    Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, Guangdong, 510080, China

    Guangdong Engineering Technology Center of Nutrition Transformation, Guangzhou, Guangdong, 510080, China
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      Highlights

      • This study was the first study to evaluate the association of liver fibrosis scores with mortality risk in CAD patients.
      • Greater liver fibrosis scores were associated with higher risk of mortality in CAD patients.
      • Liver fibrosis scores might play a potential role on CAD prognosis prediction.

      Abstract

      Background and aims

      Fatty liver diseases are highly prevalent in patients with coronary artery disease (CAD) and might progress to irreversible liver fibrosis. Whether baseline liver fibrosis (LF) scores are associated with long-term mortality among patients with CAD requires investigation.

      Methods

      The analysis was conducted based on a prospective cohort study among 3263 patients with CAD in China. Cox models were used to assess the association of baseline levels of LF scores, including non-alcoholic fatty liver disease fibrosis score (NFS), fibrosis 4 score (FIB-4), aspartate aminotransferase to platelet ratio index (APRI), gamma-glutamyltransferase to platelet ratio (GPR), and Forns score, with the risk of all-cause and cardiovascular mortality among CAD patients.

      Results

      During a median follow-up period of 7.56 (inter-quartile range: 6.86–8.31) years, 538 deaths were identified, 319 of those were due to cardiovascular diseases. Compared with patients with lowest score levels, multivariable-adjusted HRs (95% CI) for those with highest levels of NFS, FIB-4, APRI, GPR and Forns score were 2.89 (2.14–3.91), 2.84 (2.14–3.76), 1.77 (1.33–2.36), 1.47 (1.19–1.83) and 3.10 (1.88–5.11) for all-cause mortality, 3.02 (2.05–4.45), 3.34 (2.29–4.86), 1.99 (1.40–2.83), 1.80 (1.36–2.39) and 2.43 (1.28–4.61) for cardiovascular mortality, respectively. These associations were consistent when we excluded those who died within the first year of follow-up or stratified patients by different sex, age, BMI, diabetes status, metabolic syndrome status, CAD type and hsCRP level.

      Conclusions

      Higher LF scores are associated with increased risks of all-cause and cardiovascular mortality among CAD patients. LF scores might play a potential role in CAD prognosis prediction.

      Graphical abstract

      Keywords

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