CVD

CVD investigates the incidence, risk factors, and premature mortality of cardiovascular disease across five liver conditions using population-wide electronic health records from England covering 1998–2020 (nearly four million adults).

Key Features:

• Data Source: Utilizes population-wide electronic health records (EHRs) from England spanning 1998–2020 covering nearly four million adults.
• Liver Conditions Analyzed: Focuses on alcoholic liver disease (ALD), autoimmune liver disease, chronic hepatitis B infection (HBV), chronic hepatitis C infection (HCV), and non-alcoholic fatty liver disease (NAFLD).
• CVD Manifestations: Examines 17 different manifestations of cardiovascular disease to capture the spectrum of cardiovascular complications in liver disease patients.
• Statistical Analysis: Employs Cox proportional hazards models to estimate associations between biomarkers, comorbidities, and risk of developing CVD among individuals with liver disease.
• Excess Years of Life Lost (YLL): Calculates excess years of life lost attributable to CVD for each type of liver condition to quantify premature mortality.

Scientific Applications:

• Regional Variation: Identifies regional differences in incidence burden, with higher incidences reported in the North West and North East of England.
• Incidence Comparison: Quantifies higher CVD incidence in patients with liver disease versus those without (2634.6 vs. 1339.7 per 100,000 persons).
• Risk Factor Associations: Reveals strong associations between body mass index, smoking, diabetes, hypertension, and other comorbidities with increased CVD risk in liver disease patients.
• Biomarker Associations: Highlights associations of low albumin, elevated C-reactive protein, and raised International Normalized Ratio (INR) with increased CVD risk.

Methodology:

Uses population-wide EHR data (1998–2020) for nearly four million adults in England; applies Cox proportional hazards models to estimate associations between biomarkers and comorbidities and CVD risk; calculates excess years of life lost (YLL) attributable to CVD for each liver condition.