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冠心病患者和非冠心病患者主要不良心血管事件与肝纤维化评分之间的关联:来自FU-CCTA注册研究

Association between Major Adverse Cardiovascular Events and the Liver Fibrosis Score in Patients with and without Coronary Artery Disease: From the FU-CCTA Registry.

作者信息

Ajimu Yusuke, Shiga Yuhei, Hirata Tetsuo, Tashiro Kohei, Higashi Sara, Kawahira Yuto, Suematsu Yasunori, Kato Yuta, Kuwano Takashi, Sugihara Makoto, Miura Shin-Ichiro

机构信息

Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0133, Japan.

Department of Internal Medicine, Fukuoka University Nishijin Hospital, Fukuoka 814-0005, Japan.

出版信息

J Clin Med. 2023 Sep 15;12(18):5987. doi: 10.3390/jcm12185987.

Abstract

The liver fibrosis score reflects the degree of hepatic scarring and has been reported to be associated with cardiovascular disease. Using a coronary artery computed tomography angiography registry at the Fukuoka University Hospital (FU-CCTA registry), we investigated the association between major adverse cardiovascular events (MACEs) and the liver fibrosis score (fibrosis-4 index (FIB-4I)) in 612 patients who underwent CCTA to screen for coronary artery disease and performed a prognosis survey for up to 5 years. The primary endpoint was MACEs (all-cause mortality, acute myocardial infarction, ischemic stroke, coronary revascularization). FIB-4I in all patients and in patients with hypertension (HTN) was significantly higher in the MACE group than in the non-MACE group. The event-free survival rate of MACEs targeting only patients with HTN was significantly lower in patients with a high risk of liver fibrosis (FIB-4I values of 2.67 or higher) than in those with a low or intermediate risk (less than 2.67). However, no significant difference was observed in all patients or in patients without HTN. Finally, FIB-4I and body mass index were independent factors associated with MACEs in patients with HTN. In conclusion, the liver fibrosis score may be an independent predictor of MACEs in hypertensive patients undergoing CCTA.

摘要

肝纤维化评分反映了肝脏瘢痕形成的程度,据报道其与心血管疾病有关。利用福冈大学医院的冠状动脉计算机断层扫描血管造影登记系统(FU-CCTA登记系统),我们调查了612例接受CTA筛查冠状动脉疾病并进行了长达5年预后调查的患者中,主要不良心血管事件(MACE)与肝纤维化评分(纤维化-4指数(FIB-4I))之间的关联。主要终点是MACE(全因死亡率、急性心肌梗死、缺血性中风、冠状动脉血运重建)。MACE组中所有患者以及高血压(HTN)患者的FIB-4I均显著高于非MACE组。仅针对HTN患者的MACE无事件生存率在肝纤维化高风险患者(FIB-4I值为2.67或更高)中显著低于低风险或中度风险患者(低于2.67)。然而,在所有患者或无HTN的患者中未观察到显著差异。最后,FIB-4I和体重指数是HTN患者中与MACE相关的独立因素。总之,肝纤维化评分可能是接受CTA的高血压患者中MACE的独立预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8f2/10532007/bc5c0c2badf2/jcm-12-05987-g001.jpg

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