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Fibrosis tool also warns of CVD risk

09 Jan 2021
This is a liver section that shows liver fibrosis revealed by staining of collagen accumulation in a mouse with human-like NASH. Credit: UC San Diego Health.

Liver fibrosis, as determined by the fibrosis-4 (FIB-4) score, is an independent risk factor for cardiovascular disease (CVD) in healthy people, a recent study has shown.

The study included a historical cohort consisting of 8,511 individuals, of whom 3,292 had inconclusive fibrosis and 195 had advanced fibrosis (FIB-4 score ≥2.67). Participants were drawn from a centralized computerized personal medical record repository, which was monitored for the occurrence of a fatal or nonfatal myocardial infarction (MI) or a stroke event.

Over an average follow-up duration of 3,143±992.17 days, a total of 1,786 CVD events occurred, yielding an incidence rate of 20.98 percent. There was a total of 424 and 737 stroke and ischaemic heart disease episodes. A total of 913 patients died, with a mortality rate of 10.73 percent.

Kaplan-Meier curves showed that CVD survival rates were significantly lowered among participants with inconclusive fibrosis, and even more so in those with advanced fibrosis.

Cox regression analysis, fully adjusted for confounders such as aspirin and statin use and other comorbidities, confirmed that advanced fibrosis was a significant predictor for the occurrence of CVD events (hazard ratio [HR], 1.63, 95 percent confidence interval [CI], 1.29–2.06). Inconclusive fibrosis achieved borderline significance (HR, 1.08, 95 percent CI, 0.97–1.19).

“FIB-4 is simple to use at point-of-care by using web-based calculators or by implementation into computerized medical records. In addition, FIB-4 incurs minimal costs since it is based on widely available routine blood tests,” the researcher said.

“Such an approach may also be used in the future for CVD risk stratification and to promote early implementation of prevention measures within the primary care setting,” they added.

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Most Read Articles
01 Dec 2020
Tetanus toxoid 5 Lf, diphtheria toxoid 2 Lf, pertussis toxoid 2.5 mcg, filamentous haemagglutinin 5 mcg, fimbriae types 2 and 3 5 mcg, pertactin 3 mcg
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Pearl Toh, 26 Nov 2020
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