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Systematic screening for advanced liver fibrosis in patients with coronary artery disease: The CORONASH study
Although coronary artery disease (CAD) and advanced liver fibrosis (AdLF) are commonly associated in patients with non-alcoholic fatty liver disease (NAFLD), the prevalence of AdLF and the diagnostic performance of non-invasive fibrosis tests (NITs) in CAD patients remains unknown. We aimed to prosp...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9135299/ https://www.ncbi.nlm.nih.gov/pubmed/35617294 http://dx.doi.org/10.1371/journal.pone.0266965 |
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author | Thévenot, Thierry Vendeville, Sophie Weil, Delphine Akkouche, Linda Calame, Paul Canivet, Clémence M. Vanlemmens, Claire Richou, Carine Cervoni, Jean-Paul Seronde, Marie-France Di Martino, Vincent Boursier, Jérôme |
author_facet | Thévenot, Thierry Vendeville, Sophie Weil, Delphine Akkouche, Linda Calame, Paul Canivet, Clémence M. Vanlemmens, Claire Richou, Carine Cervoni, Jean-Paul Seronde, Marie-France Di Martino, Vincent Boursier, Jérôme |
author_sort | Thévenot, Thierry |
collection | PubMed |
description | Although coronary artery disease (CAD) and advanced liver fibrosis (AdLF) are commonly associated in patients with non-alcoholic fatty liver disease (NAFLD), the prevalence of AdLF and the diagnostic performance of non-invasive fibrosis tests (NITs) in CAD patients remains unknown. We aimed to prospectively screen for AdLF in patients with documented CAD using NITs and Fibroscan. High and intermediate zones of NITs were combined to define AdLF. AdLF was suspected whenever APRI ≥ 0.5, Forns index ≥ 4.2, NAFLD fibrosis score (NFS) ≥ -1.455/0.12 for age </≥ 65 yrs), Fib4 (≥ 1.30/2.0 for age </≥ 65 yrs) and eLIFT≥ 8. A presumed AdLF assessed by Fibroscan ≥ 8 kPa was the primary outcome measure. Results were given on the basis of intent-to-diagnose liver stiffness ≥ 8 kPa. Among 189 patients (age 60±7years), 10 (5.3%) had a Fibroscan ≥ 8 kPa, of whom 5 underwent liver biopsy (F3/F4: n = 3; no fibrosis: n = 2). AdLF was suspected in 31% of cases using eLIFT (specificity, Sp 70%), 85% with Forns (Sp 16%), 38% with NFS (Sp 63%), 25% with Fib4 (Sp 74%), and 10% with APRI (Sp 91%). In 149 patients “at-risk” of NAFLD (i.e., elevated ALT or diabetes or hypertriglyceridemia or BMI ≥25 kg/m(2)), AdLF ranged between 10% (APRI) to 84% (Forns). In this subgroup, the most efficient NITs to predict Fibroscan ≥ 8 kPa were eLIFT (Se 60%, Sp 70%) and NFS (Se 70%, Sp 60%). Finally, in CAD patients with risk factors for NAFLD, NFS or the more user-friendly eLIFT are the most attractive first-line biochemical NITs to discriminate good candidates for Fibroscan. |
format | Online Article Text |
id | pubmed-9135299 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-91352992022-05-27 Systematic screening for advanced liver fibrosis in patients with coronary artery disease: The CORONASH study Thévenot, Thierry Vendeville, Sophie Weil, Delphine Akkouche, Linda Calame, Paul Canivet, Clémence M. Vanlemmens, Claire Richou, Carine Cervoni, Jean-Paul Seronde, Marie-France Di Martino, Vincent Boursier, Jérôme PLoS One Research Article Although coronary artery disease (CAD) and advanced liver fibrosis (AdLF) are commonly associated in patients with non-alcoholic fatty liver disease (NAFLD), the prevalence of AdLF and the diagnostic performance of non-invasive fibrosis tests (NITs) in CAD patients remains unknown. We aimed to prospectively screen for AdLF in patients with documented CAD using NITs and Fibroscan. High and intermediate zones of NITs were combined to define AdLF. AdLF was suspected whenever APRI ≥ 0.5, Forns index ≥ 4.2, NAFLD fibrosis score (NFS) ≥ -1.455/0.12 for age </≥ 65 yrs), Fib4 (≥ 1.30/2.0 for age </≥ 65 yrs) and eLIFT≥ 8. A presumed AdLF assessed by Fibroscan ≥ 8 kPa was the primary outcome measure. Results were given on the basis of intent-to-diagnose liver stiffness ≥ 8 kPa. Among 189 patients (age 60±7years), 10 (5.3%) had a Fibroscan ≥ 8 kPa, of whom 5 underwent liver biopsy (F3/F4: n = 3; no fibrosis: n = 2). AdLF was suspected in 31% of cases using eLIFT (specificity, Sp 70%), 85% with Forns (Sp 16%), 38% with NFS (Sp 63%), 25% with Fib4 (Sp 74%), and 10% with APRI (Sp 91%). In 149 patients “at-risk” of NAFLD (i.e., elevated ALT or diabetes or hypertriglyceridemia or BMI ≥25 kg/m(2)), AdLF ranged between 10% (APRI) to 84% (Forns). In this subgroup, the most efficient NITs to predict Fibroscan ≥ 8 kPa were eLIFT (Se 60%, Sp 70%) and NFS (Se 70%, Sp 60%). Finally, in CAD patients with risk factors for NAFLD, NFS or the more user-friendly eLIFT are the most attractive first-line biochemical NITs to discriminate good candidates for Fibroscan. Public Library of Science 2022-05-26 /pmc/articles/PMC9135299/ /pubmed/35617294 http://dx.doi.org/10.1371/journal.pone.0266965 Text en © 2022 Thévenot et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Thévenot, Thierry Vendeville, Sophie Weil, Delphine Akkouche, Linda Calame, Paul Canivet, Clémence M. Vanlemmens, Claire Richou, Carine Cervoni, Jean-Paul Seronde, Marie-France Di Martino, Vincent Boursier, Jérôme Systematic screening for advanced liver fibrosis in patients with coronary artery disease: The CORONASH study |
title | Systematic screening for advanced liver fibrosis in patients with coronary artery disease: The CORONASH study |
title_full | Systematic screening for advanced liver fibrosis in patients with coronary artery disease: The CORONASH study |
title_fullStr | Systematic screening for advanced liver fibrosis in patients with coronary artery disease: The CORONASH study |
title_full_unstemmed | Systematic screening for advanced liver fibrosis in patients with coronary artery disease: The CORONASH study |
title_short | Systematic screening for advanced liver fibrosis in patients with coronary artery disease: The CORONASH study |
title_sort | systematic screening for advanced liver fibrosis in patients with coronary artery disease: the coronash study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9135299/ https://www.ncbi.nlm.nih.gov/pubmed/35617294 http://dx.doi.org/10.1371/journal.pone.0266965 |
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