CVD Risk in NAFLD May Rise When Advanced Fibrosis Is Present

Adults with nonalcoholic fatty liver disease (NAFLD) may be at an even greater risk for incident cardiovascular disease (CVD) if they have advanced fibrosis, according to results of a new study.

“In adults with biopsy‐proven NAFLD, advanced fibrosis on biopsy and higher NAFLD fibrosis score were significant and independent predictors of incident cardiovascular disease, even after considering traditional risk factors and cardiovascular (CV) risk scores,” the study authors wrote.

To identify predictors of incident CVD, the researchers performed a competing risks analysis using data of 285 adults with NAFLD without CVD enrolled in a tissue repository from 2011 to 2018. The participants were prospectively followed up from enrollment until the first recorded date of incident CVD, mortality, or November 1, 2018.

Of the 285 participants who were followed up for a median 5.2 years, 26 (9.1%) had an incident CVD event.

Advanced fibrosis on biopsy was determined to be a significant predictor of incident CVD. The association continued even after relevant covariates were considered.

The NAFLD fibrosis score was the only independent predictor of CVD among the noninvasive indicators of fibrosis. 

According to the study authors, there was no association between other histologic features, such as steatohepatitis and incident CVD.

“These findings should be considered when evaluating NAFLD patients for primary prevention of cardiovascular disease, and further evaluation into the link between advanced fibrosis and cardiovascular disease is needed,” the researchers concluded.

—Colleen Murphy

Reference:

Henson JB, Simon TG, Kaplan A, Osganian S, Masia R, Corey KE. Advanced fibrosis is associated with incident cardiovascular disease in patients with non‐alcoholic fatty liver disease [published online February 11, 2020]. Aliment Pharmacol Ther. doi:10.1111/apt.15660.