Cardiometabolic & kidneyCohort study
Subclinical liver disease and incident cardiovascular events
- Prospective cohort study
Authors' conclusion
These findings establish subclinical liver disease-through steatosis, fibrosis, and functional impairment-as an independent and synergistic determinant of CVD risk.
Study context
- Population
- Participants free of clinical liver disease and cardiovascular disease (CVD) at baseline
- Participants
- 318,308 participants
- Exposure
- Highest vs lowest quartile of FLI, FIB-4 and albumin-bilirubin (ALBI) score
- Outcome
- Major incident CVD events:
- MI
- HF
- AF
- Ischaemic stroke
- CV death
- Follow-up
- Median 14.0 years
Main finding
As reported in the abstract
Incident CVD
Each group vs Q1Adjusted hazard ratio (95% CI)
Q4FLI (steatosis)
1.46(1.40–1.52)
Q4FIB-4 (fibrosis)
1.66(1.60–1.73)
Q4ALBI score (functional reserve)
1.42(1.37–1.47)
All three Q4synergistic risk
2.53(2.38–2.70)
- Incident CVD events overall
- 32 637 (10.3%)
Observational data: associations, not effects.
Further findings
Incident CVD, by sex (subgroup)
- FLI more strongly associated with CVD in women; FIB-4 and ALBI greater risk in men
Sensitivity analyses and specific CVD endpoints
- Results consistent
Original publication
Subclinical liver disease and incident cardiovascular events. Eur Heart J. Published 7 September 2026. doi:10.1093/eurheartj/ehag700
Summarised from the published abstract; every number is checked against it