Abstract 14635: The Fib-4 Index is a Risk Factor for Incident Cardiovascular Disease in Urban Male Residents: The Suita Study

Abstract

Introduction: The fibrosis index based on four factors (FIB-4 index) is a score that predicts liver fibrosis easily, quickly, and inexpensively, but there is little evidence of its relationship with the onset of cardiovascular disease in general population in Japan. Therefore, we examined the relationship between incident cardiovascular disease (CVD) by the FIB-4 index level in urban area residents. Methods: We studied 5,333 follow-up Japanese individuals (2,478 men, 2,855 women) with no history of CVD in the Suita Study. The platelet count was measured at the time of medical examination. The FIB-4 index was calculated using age (yrs), alanine aminotransferase (ALT, IU/L), aspartate aminotransferase (AST, IU/L), and platelet count (PLT, 10^9/L) as follow: FIB-4 index = (AST x Age) / (PLT x (square root of ALT)). The primary endpoint was CVD events, including stroke or ischemic heart disease. The risk of CVD was analyzed by the FIB-4 index level using the Cox proportional hazards model adjusted by the components of the ischemic heart disease risk score in the Suita Study. Results: The percentage of the FIB-4 index ≥2.67 in the 30s to 80s at the baseline survey was 0%, 1%, 2%, 7,%, 21%, 43% for men, and 0%, 0%, 1%, 5%, 16%, 39% for women, respectively. During the mean follow-up period of 9.3 years, 195 strokes and 137 ischemic heart diseases were observed. Based on men with FIB-4 index <1.30, the adjusted hazard ratio (95% confidence interval) for incident CVD in men with FIB-4 index ≥2.67 was 1.91 (1.05-3.47), those for incident ischemic heart disease in men with FIB-4 index 1.30-2.66 and ≥2.67 were 2.49 (1.33-4.64) and 3.29 (1.32-8.16), respectively. Conclusion: The FIB-4 index was considered to be useful as a predictor of ischemic heart disease in urban men in Japan.