Association of liver fibrosis scores with all‐cause and cardiovascular mortality in patients with heart failure

作者：Ziyu Guo, Zixiang Ye, Qinfeng Xu, Yike Li, Jingang Zheng · 发表于：Clinical and Translational Science · 年份：2024 · DOI：10.1111/cts.70104 · 被引用次数：8 · 研究领域：Liver Disease Diagnosis and Treatment、Liver Disease and Transplantation、Nutrition and Health in Aging

The aim of this study was to examine the relationship of liver fibrosis (determined via fibrosis scores) with all-cause mortality and cardiovascular mortality in HF patients. The study examined demographic and clinical data were collected from NHANES database (1999 to 2018). A total of 1356 HF patients were enrolled in our analysis. During a median follow-up time of 70 months, 455 patients died. Compared to the survivors, the death group showed significantly elevated LFSs levels. RCS analysis revealed a linear relationship between various LFSs and all-cause and cardiovascular mortality. KM curves and Cox regression models indicated that higher FIB-4 (≥ 1.637), NFS (≥ -0.064), and AST/ALT ratio (≥ 1.172) were linked to higher risk of all-cause mortality [Cox model 2: FIB-4 adjusted hazard ratio (aHR), 1.24; 95% CI, 1.04-1.48; NFS aHR, 1.19; 95% CI, 1.01-1.38; AST/ALT ratio aHR, 1.25; 95% CI, 1.07-1.47] and cardiovascular mortality in heart failure patients (FIB-4 aHR, 1.28; 95% CI, 1.07-1.67; AST/ALT ratio aHR, 1.39; 95% CI, 1.08-1.79). ROC curves indicated that FIB-4, NFS, and the AST/ALT ratio were important predicators of all-cause mortality (AUC: 0.715, 0.707, and 0.715, respectively) and cardiovascular mortality (AUC: 0.658, 0.657, and 0.659, respectively) in heart failure patients. Random survival forests showed that FIB-4, AST/ALT ratio, and NFS emerged as important factors potentially influencing mortality of HF. Consistent associations were observed in subgroup analys...