Liver stiffness predicts progression to liver-related events in patients with chronic liver disease - A cohort study...

Area of Science:

• Hepatology
• Diagnostic Biomarkers
• Non-invasive Liver Assessment

Background:

• Liver stiffness measurement (LSM) via vibration-controlled transient elastography (VCTE) is a non-invasive biomarker for liver fibrosis.
• The predictive value of LSM for future liver-related outcomes in diverse populations remains uncertain.

Purpose of the Study:

• To evaluate the association between LSM by VCTE and the risk of developing cirrhosis with portal hypertension or hepatocellular carcinoma (HCC).
• To assess the discriminative ability of VCTE in predicting liver-related outcomes in a large, heterogeneous cohort.

Main Methods:

• A multi-centre Swedish cohort study included 14,414 patients undergoing VCTE between 2008 and 2020.
• Outcomes (cirrhosis with portal hypertension, HCC) were tracked via national registers.
• Cox regression analysis and Harrel's C-index were used to determine hazard ratios and VCTE's discriminative ability.

Main Results:

• Over a median follow-up of 5.9 years, 2.7% of patients developed cirrhosis with portal hypertension.
• Patients with LSM ≥25 kPa had a significantly higher risk (28.7% within 5 years) compared to those with LSM <10 kPa (0.6%), yielding a hazard ratio of 48.3.
• VCTE demonstrated high discriminative ability (C-indices >0.80) for most liver diseases, including MASLD (0.82), with similar findings for HCC.

Conclusions:

• Elevated LSM by VCTE is strongly associated with an increased risk of progression to cirrhosis with portal hypertension and HCC.
• VCTE exhibits high discriminative power across various chronic liver disease etiologies.
• These findings support the utility of VCTE in guiding patient follow-up and treatment decisions for liver disease.