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A total of 21,715 adults aged 40\u00a0years and older were enrolled at baseline. The mean follow-up period was 12.39\u00a0years. Three types of NITs (fibrosis-4 index [FIB-4], NAFLD fibrosis score [NFS], and steatosis-associated fibrosis estimator [SAFE] score) were used. When using the low cut-off as a 'rule-out' strategy, there were no significant differences in cardiovascular mortality between the 'rule-out' (low-risk) group and the 'rule-in' (intermediate- or high-risk) group based on FIB-4 (aHR\u2009=\u20091.029, <jats:italic>P<\/jats:italic>\u2009=\u20090.845) or NFS (aHR\u2009=\u20090.839, <jats:italic>P<\/jats:italic>\u2009=\u20090.271) classification. However, the SAFE score exhibited higher sensitivity in predicting cardiovascular mortality compared to FIB-4 or NFS (73.3% in SAFE score vs. 29.6% in FIB-4 or 21.3% in NFS). Only the SAFE score could effectively differentiate the risk between low- and intermediate- or high-risk groups for all types of mortality (all <jats:italic>P<\/jats:italic> values for aHR\u2009&lt;\u20090.001). The low cutoff value of the SAFE score discriminated not only liver-related mortality but also identified the cardiovascular high-risk group in the community cohort.<\/jats:p>","DOI":"10.1038\/s41598-024-56085-3","type":"journal-article","created":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T17:03:29Z","timestamp":1711472609000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparative evaluation of non-invasive tests for risk stratification for cause specific mortality in at-risk population of hepatic fibrosis"],"prefix":"10.1038","volume":"14","author":[{"given":"Huiyul","family":"Park","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eileen L.","family":"Yoon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mimi","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hye-Lin","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mi Kyung","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Mi","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae Won","family":"Jun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,26]]},"reference":[{"key":"56085_CR1","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1002\/hep.32228","volume":"75","author":"JM Paik","year":"2022","unstructured":"Paik, J. 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