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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
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.
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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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