Racial Difference in Cardiovascular Outcome in Patients with Advanced Hepatic Fibrosis Restricted; Files Only
Getachew, Bereket (Spring 2024)
Abstract
Background: Patients with coronary artery disease (CAD) have remained a high-risk cohort for cardiovascular morbidity and mortality despite improvements in clinical care. Cardiovascular mortality remains higher in Black compared to White individuals.1 Advanced hepatic fibrosis (AHF), known to be an independent risk factor for cardiovascular mortality, is increasing in prevalence across all racial groups.2-4 This study aims to assess the association between AHF and cardiovascular mortality amongst different racial groups. Our hypothesis was that advanced liver fibrosis will be associated with a higher risk of mortality among Black individuals compared to White individuals.
Method: 3263 patients undergoing diagnostic coronary angiography were enrolled in the Emory Cardiovascular Biobank. The presence of liver fibrosis was calculated using the Fibrosis-4 score, which is a validated non-invasive score to identify patients with liver fibrosis, with a score ≥2.67 indicating advanced liver fibrosis. A Cox regression model, adjusting for known cardiovascular risk factors, including age, sex, race, diabetes, ever smoking, hypertension, BMI, eGFR and CAD history was utilized to analyze the relationship between AHF and cardiovascular mortality in Black and White participants.
Results: Of the total 3263 participants, 25.6% were Black, and 505 had AHF (381 White and 104 Black). AHF was significantly associated with all causes of death (1.41 [1.19, 1.58], P < 0.001) and cardiovascular death (1.38 [1.09, 1.74], P < 0.007) compared to those without AHF, after adjustment for aforementioned covariates. Similarly, AHF was associated with higher rates of cardiovascular death in both Black and White participants, (1.36 [1.05, 1.77], P < 0.02, 1.47 [0.84, 2.56], P = 0.17, respectively, although the higher rate was not significant among Black participants.
Conclusion: AHF is independently associated with higher cardiovascular mortality in both Black and White patients with CAD, with insignificant racial differences.
Table of Contents
Table of Contents
Background……………………………………………………………1
Methods………………………………………………………………..6
Results…………………………………………………………………..8
Discussion ……………………………………………………….….17
Strength and limitation………………………………………..18
Clinical Implication………………………………………………19
Conclusion and Future Directions………………………..19
Sources………………………………………………………………..20
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File download under embargo until 24 May 2026 | 2024-04-15 10:42:28 -0400 | File download under embargo until 24 May 2026 |
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