Imperial College London
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ProfessorJamilMayet

Faculty of Medicine, National Heart & Lung Institute

Professor of Cardiology
 
 
 
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Contact

 

+44 (0)20 7594 1006j.mayet

 
 
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Assistant

 

Miss Juliet Holmes +44 (0)20 7594 5735

 
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Location

 

NHLI offices,Sir Michael Uren HubWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Abeles:2019:10.1111/apt.15192,
author = {Abeles, RD and Mullish, BH and Forlano, R and Kimhofer, T and Adler, M and Tzallas, A and Giannakeas, N and Yee, M and Mayet, J and Goldin, RD and Thursz, MR and Manousou, P},
doi = {10.1111/apt.15192},
journal = {Alimentary Pharmacology and Therapeutics},
pages = {1077--1085},
title = {Derivation and validation of a cardiovascular risk score for prediction of major acute cardiovascular events in non-alcoholic fatty liver disease; the importance of an elevated mean platelet volume},
url = {http://dx.doi.org/10.1111/apt.15192},
volume = {49},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background:  Atherosclerotic  cardiovascular  disease  is  a  key  cause  of  morbidity  in  non-alcoholic   fatty   liver   disease   (NAFLD)   but   appropriate   means   to   predict   major   acute cardiovascular events (MACE) are lacking. Aims: To design a bespoke cardiovascular risk score in NAFLD. Methods:  A retrospective derivation (2008-2016, 356 patients) and a prospective validation (2016-  2017,  111  patients)  NAFLD  cohort  study  was  performed.  Clinical  and  biochemical data were recorded at enrolment and mean platelet volume (MPV), Qrisk2 and Framingham scores  were  recorded  one  year  prior  to  MACE  (Cardiovascular  death,  acute  coronary syndrome, stroke, and transient ischaemic attack). Results:  The  derivation  and  validation  cohorts  were  well  matched  with  MACE  prevalence 12.6%  and  12%  respectively.  On  univariate  analysis,  age,  diabetes,  advanced  fibrosis, collagen proportionate area >5%, MPV and liver stiffness were associated with MACE. After multivariate  analysis,  age,  diabetes  and  MPV  remained  independently  predictive.  The ‘NAFLD CV-risk score’ was generated using binary logistic regression: 85860.06(Age) + 0.963(MPV) + 0.26(DM1) – 16.441 Diabetes mellitus: 1: present; 2: absent. (AUROC 0.84). A cut-off of -3.98 gave a Sensitivity 97%, Specificity 27%, PPV 16%, NPV 99%. An  MPV  alone  of  >10.05  gave  a  sensitivity  97%,  specificity  59%,  PPV  24%  and  NPV  97% (AUROC 0.83). Validation cohort AUROCs were comparable at 0.77 (NAFLD CV-risk) and 0.72 (MPV). In the full cohort, the NAFLD CV-risk score and MPV outperformed both Qrisk2 and Framingham scores. Conclusions:  The  NAFLD  CV  risk  score  and  MPV  accurately  predict  1-year  risk  of  MACE thereby   allowing   better   identification   of   patients   that   require   optimisation   of   their cardiovascular risk profile.
AU  - Abeles,RD
AU  - Mullish,BH
AU  - Forlano,R
AU  - Kimhofer,T
AU  - Adler,M
AU  - Tzallas,A
AU  - Giannakeas,N
AU  - Yee,M
AU  - Mayet,J
AU  - Goldin,RD
AU  - Thursz,MR
AU  - Manousou,P
DO  - 10.1111/apt.15192
EP  - 1085
PY  - 2019///
SN  - 0269-2813
SP  - 1077
TI  - Derivation and validation of a cardiovascular risk score for prediction of major acute cardiovascular events in non-alcoholic fatty liver disease; the importance of an elevated mean platelet volume
T2  - Alimentary Pharmacology and Therapeutics
UR  - http://dx.doi.org/10.1111/apt.15192
UR  - http://hdl.handle.net/10044/1/67225
VL  - 49
ER  -
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