In:
Alimentary Pharmacology & Therapeutics, Wiley, Vol. 49, No. 8 ( 2019-04), p. 1077-1085
Abstract:
Atherosclerotic cardiovascular disease is a key cause of morbidity in non‐alcoholic fatty liver disease (NAFLD) but appropriate means to predict major acute cardiovascular events (MACE) are lacking. Aim To design a bespoke cardiovascular risk score in NAFLD. Methods A retrospective derivation (2008‐2016, 356 patients) and a prospective validation (2016‐ 2017, 111 patients) NAFLD cohort study was performed. Clinical and biochemical data were recorded at enrolment and mean platelet volume (MPV), Qrisk2 and Framingham scores were recorded one year prior to MACE (Cardiovascular death, acute coronary syndrome, stroke and transient ischaemic attack). Results The derivation and validation cohorts were well‐matched, with MACE prevalence 12.6% and 12%, respectively. On univariate analysis, age, diabetes, advanced fibrosis, collagen proportionate area 〉 5%, MPV and liver stiffness were associated with MACE. After multivariate analysis, age, diabetes and MPV remained independently predictive of MACE. The “NAFLD CV‐risk score” was generated using binary logistic regression: 0.06*(Age) + 0.963*(MPV) + 0.26*(DM 1 ) – 16.44; 1 Diabetes mellitus: 1: present; 2: absent. (AUROC 0.84). A cut‐off of −3.98 gave a sensitivity 97%, specificity 27%, PPV 16%, and NPV 99%. An MPV alone of 〉 10.05 gave a sensitivity 97%, specificity 59%, PPV 24% and NPV 97% (AUROC 0.83). Validation cohort AUROCs were comparable at 0.77 (NAFLD CV‐risk) and 0.72 (MPV). In the full cohort, the NAFLD CV‐risk score and MPV outperformed both Qrisk2 and Framingham scores. Conclusions The NAFLD CV risk score and MPV accurately predict 1‐year risk of MACE, thereby allowing better identification of patients that require optimisation of their cardiovascular risk profile.
Type of Medium:
Online Resource
ISSN:
0269-2813
,
1365-2036
DOI:
10.1111/apt.2019.49.issue-8
Language:
English
Publisher:
Wiley
Publication Date:
2019
detail.hit.zdb_id:
2003094-0
SSG:
15,3
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