The Framingham risk score and heart disease in nonalcoholic fatty liver disease

Sombat Treeprasertsuk, Scott Leverage, Leon A. Adams, Keith D. Lindor, Jennifer St. Sauver, Paul Angulo

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

The accuracy of the Framingham risk score (FRS) in identifying patients with nonalcoholic fatty liver disease (NAFLD) at higher 10-year coronary heart disease (CHD) risk remains unknown. We aimed at evaluating both the baseline probability of CHD as predicted by the FRS and the actual long-term occurrence of CHD in NAFLD patients. This was a longitudinal study of a community-based cohort. A total of 309 NAFLD patients were followed up for 11.5 ± 4.1 years (total 3554 person-years). The overall calculated 10-year CHD risk was significantly higher in the NAFLD cohort than the absolute CHD risk predicted by the FRS for persons of the same age and gender (10.9 ± 9.3% vs. 9.9 ± 5.9%, respectively, P < 0.0001), and higher in men than women (12.6 ± 10.3% vs. 9.6 ± 8.1%, respectively, P = 0.006). New onset CHD occurred in 34 patients (11% vs. 10.9% predicted at baseline, P = NS), whereas 279 (89%) patients did not develop CHD. Using multivariable analysis, the FRS was the only variable significantly associated with new onset CHD (OR = 1.13, 95% CI = 1.05-1.21; P = 0.001). A FRS cut-point of 11 in women, and 6 in men had a sensitivity of 80% and 74%, respectively, and a negative predictive value of 97% and 93% respectively. NAFLD patients have a higher 10-year CHD risk than the general population of the same age and gender. The FRS accurately predicts the higher 10-year CHD risk in NAFLD patients, and helps identify those patients expected to derive the most benefit from early intervention to prevent CHD events.

Original languageEnglish (US)
Pages (from-to)945-950
Number of pages6
JournalLiver International
Volume32
Issue number6
DOIs
StatePublished - Jul 2012

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Coronary Disease
Heart Diseases
Non-alcoholic Fatty Liver Disease
Longitudinal Studies

ASJC Scopus subject areas

  • Hepatology

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The Framingham risk score and heart disease in nonalcoholic fatty liver disease. / Treeprasertsuk, Sombat; Leverage, Scott; Adams, Leon A.; Lindor, Keith D.; St. Sauver, Jennifer; Angulo, Paul.

In: Liver International, Vol. 32, No. 6, 07.2012, p. 945-950.

Research output: Contribution to journalArticle

Treeprasertsuk, Sombat ; Leverage, Scott ; Adams, Leon A. ; Lindor, Keith D. ; St. Sauver, Jennifer ; Angulo, Paul. / The Framingham risk score and heart disease in nonalcoholic fatty liver disease. In: Liver International. 2012 ; Vol. 32, No. 6. pp. 945-950.
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abstract = "The accuracy of the Framingham risk score (FRS) in identifying patients with nonalcoholic fatty liver disease (NAFLD) at higher 10-year coronary heart disease (CHD) risk remains unknown. We aimed at evaluating both the baseline probability of CHD as predicted by the FRS and the actual long-term occurrence of CHD in NAFLD patients. This was a longitudinal study of a community-based cohort. A total of 309 NAFLD patients were followed up for 11.5 ± 4.1 years (total 3554 person-years). The overall calculated 10-year CHD risk was significantly higher in the NAFLD cohort than the absolute CHD risk predicted by the FRS for persons of the same age and gender (10.9 ± 9.3{\%} vs. 9.9 ± 5.9{\%}, respectively, P < 0.0001), and higher in men than women (12.6 ± 10.3{\%} vs. 9.6 ± 8.1{\%}, respectively, P = 0.006). New onset CHD occurred in 34 patients (11{\%} vs. 10.9{\%} predicted at baseline, P = NS), whereas 279 (89{\%}) patients did not develop CHD. Using multivariable analysis, the FRS was the only variable significantly associated with new onset CHD (OR = 1.13, 95{\%} CI = 1.05-1.21; P = 0.001). A FRS cut-point of 11 in women, and 6 in men had a sensitivity of 80{\%} and 74{\%}, respectively, and a negative predictive value of 97{\%} and 93{\%} respectively. NAFLD patients have a higher 10-year CHD risk than the general population of the same age and gender. The FRS accurately predicts the higher 10-year CHD risk in NAFLD patients, and helps identify those patients expected to derive the most benefit from early intervention to prevent CHD events.",
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