Use of non-invasive scores for the estimation of mortality risk in patients with Non-Alcoholic Fatty Liver Disease

Although non-alcoholic fatty liver disease (NAFLD) is rarely associated with the progression to chronic liver disease and its complications, it remains a major public health concern due to its high prevalence and its strong association with the metabolic syndrome (MetS), with an increased risk of cardio-vascular events (CVEs) and with a higher risk of overall and cardio-vascular mortality. In this scenario, holistic treatment of NAFLD may provide prognostic benefit through a reduction of its related overall morbidity and mortality. Hence, the stratification of a patient’s individual risk of cardiovascular disease (CVD), cardiac-specific and overall mortality has a pivotal role for implementing treatment with more aggressive strategies in the high-risk patients. With this study we aim to assess the cardiovascular and liver-related risk in a prospective, observational cohort of consecutive patients with NAFLD who were referred to our Unit for evaluation of liver disease. In these patients, the risk of future cardiovascular events and of liver-related events were estimated using validated risk score calculators and non-invasive tests for fibrosis. Additionally, we aimed to evaluate the potential differences in the estimated cardiovascular and liver-related risks between patients diagnosed with MAFLD and non-MAFLD patients (i.e. patients with steatosis not fulfilling the criteria for a MAFLD diagnosis).