Liver Fibrosis Scores closely Linked to Elevated Heart Failure Risk: Study

While the association between nonalcoholic fatty liver disease and cardiovascular disease has been well described, the relationship between the fibrosis score and the risk of cardiovascular events remains unclear. The goal of this study was to evaluate the association between the scoring systems of the level of liver fibrosis and heart failure using non-invasive approaches.

This cross-sectional investigation analyzed data from the NHANES, from 2011 through 2018. The three modalities of noninvasive scoring that were used to assess the risk for liver fibrosis were administered on the 19,695 participants; these included the following:

• FIB-4 score

• NAFLD fibrosis score (NFS)

• Aspartate aminotransferase to platelet ratio index (APRI)

Key findings of the study were as follows:

Advanced Liver Fibrosis Risk Prevalence

• FIB-4 score:4.20%

• NFS score:8.06%

• APRI score:0.35%

Significant association with heart failure

• FIB-4 (continuous variable):OR 1.15 [95% CI,1.07–1.23]

• NFS:OR 1.42 [95% CI,1.23–1.64]

• APRI: OR 1.44 [95% CI, 1.15-1.81]

Results of categorical analysis:

• FIB-4 ≥2.67 vs FIB-4 <1.3: OR 2.18 [95% CI, 1.47-3.24]

• NFS ≥0.675 vs NFS <−1.455: OR 2.53 [95% CI, 1.37-4.68]

This study concludes that advanced liver fibrosis risk, as indicated by FIB-4, NFS, and APRI scores, poses a highly significant correlation with an elevated prevalence of heart failure. Such findings emphasize an integrated approach to diagnosis relating to both the hepatic and cardiovascular systems, mainly in at-risk groups.

Reference:

Liu, X., Zhang, H.-J., Fang, C.-C., Li, L., Lai, Z.-Q., Liang, N.-P., Zhang, X.-T., Wu, M.-B., Yin, X., Zhang, H., & Dong, Y.-F. (2024). Association between noninvasive liver fibrosis scores and heart failure in a general population. Journal of the American Heart Association. https://doi.org/10.1161/jaha.123.035371