Noninvasive markers of hepatic fibrosis and their clinical application in coronary artery disease.

Introduction and Objectives

Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide. Reliable knowledge of the prevalence of occult CAD, particularly anatomically confirmed CAD is limited and cardiovascular risk (CVR) models only predict the risk of an acute coronary event within a set period. It has been described that a FIB-4 score is associated with a higher CVR. Determine what is the utility of noninvasive markers of liver fibrosis in CAD.

Materials and Patients

A cross-sectional study was conducted in two tertiary centers in central and western Mexico from March 2019 to April 2023. Patients who required percutaneous coronary angiography were studied and demographic data and coronary angiographic were recorded. Noninvasive fibrosis indexes were calculated. Continuous variables were subjected to a distribution analysis and equality of variances to subsequently perform a mean comparison analysis with U-Mann-Whitney test between patients with monovascular, bivascular and trivascular involvement. A correlation analysis was also performed between the invasive markers and the Syntax index.

Results

A total of 168 patients were included with a mean age of 66 ± 12 years with a predominance of male sex with 75.6% (n= 127). Angiographic findings included 37.5%, monovascular, 32.7%, bivascular and 29.8% trivascular involvement. Comparison of means of noninvasive markers of fibrosis demonstrated a significant difference in HFS between patients with monovascular (0.17 ± 0.18), bivascular (0.27 ± 0.18) and trivascular (0.30 ± 0.25) coronary artery disease, p=< 0.001. A correlation was also demonstrated between non-invasive markers and Syntax score: FIB-4 (r=: 820, p=<0.001), APRI (r=: 766, p=<0.001), HFS (r= 869, p=<0.001), (r= 820, p=<0.001), NFS (r= 807 p=<0.001)

Conclusions

The score of noninvasive tools to assess liver fibrosis correlates positively with the complexity of CAD and could be considered as noninvasive tools to be used in the assessment CVR.