Leverage, Scott

AbstractThe accuracy of theFramingham 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 ofCHDas predicted by theFRSand the actual long‐term occurrence ofCHDinNAFLDpatients. This was a longitudinal study of a community‐based cohort. A total of 309NAFLDpatients were followed up for 11.5 ± 4.1 years (total 3554 person‐years). The overall calculated 10‐yearCHDrisk was significantly higher in theNAFLDcohort than the absoluteCHDrisk predicted by theFRSfor 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 onsetCHDoccurred in 34 patients (11% vs. 10.9% predicted at baseline,P = NS), whereas 279 (89%) patients did not developCHD. Using multivariable analysis, theFRSwas the only variable significantly associated with new onsetCHD(OR = 1.13, 95%CI = 1.05–1.21;P = 0.001). AFRScut‐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.NAFLDpatients have a higher 10‐yearCHDrisk than the general population of the same age and gender. TheFRSaccurately predicts the higher 10‐yearCHDrisk inNAFLDpatients, and helps identify those patients expected to derive the most benefit from early intervention to preventCHDevents.