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Master Thesis

Évaluation de la valeur pronostique du FibroScan chez les patients ayant fait un accident cardiovasculaire ischémique

Abstract : Background and aims: non-invasive methods for liver fibrosis assessment showed good prognostic performance in non-alcoholic fatty liver disease. The aim of this study was to assess the prognostic value of liver stiffness (assessed by FibroScan®), NAFLD Fibrosis Score and FIB-4 to predict recurrence of ischemic cardiovascular events. Methods: between April 2009 and January 2014, four patients per week were randomly assigned for having a non-invasive assessment of liver fibrosis (FibroScan®, NAFLD Fibrosis Score (NFS) and FIB-4) after being hospitalized at the Bordeaux University Hospital Center for an ischemic cardiovascular event. Data on cardiovascular, hepatic, oncologic and overall mortality were collected until december 31, 2018. Results: 351 patients were included in the study (281 men (80.1%), mean age 64 years). 40 patients (11.4%) had FibroScan® >7.9 kPa, in favor of advanced liver fibrosis. During follow-up (median of 63 months), 95 patients (27.2%) had a new cardiovascular event, of which 41 (43.1%) had a coronary event, 28 (29.5%) had a stroke, and 26 (27.4%) a complication related to a peripheral arterial disease. In multivariate analysis, liver stiffness measured by FibroScan® (relative risk = 1.03, 95% confidence interval = 1.01-1.06, p = 0.008) and NAFLD Fibrosis Score (relative risk = 1.27 95% confidence interval = 1.08-1.49, p = 0.0037) were independent factors associated with the occurrence of a cardiovascular event. Non-invasive methods were not associated with overall mortality and cancer occurrence in our cohort. Conclusion: in patients with history of ischemic cardiovascular events, FibroScan® and NAFLD Fibrosis Score are independent predictors of recurrence of cardiovascular events.
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Submitted on : Tuesday, January 7, 2020 - 4:56:41 PM
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Thomas Badouard. Évaluation de la valeur pronostique du FibroScan chez les patients ayant fait un accident cardiovasculaire ischémique. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02431069⟩



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