{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:07:14Z","timestamp":1789175234375,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","award":["RS\u20102025\u201025459146"],"award-info":[{"award-number":["RS\u20102025\u201025459146"]}],"id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background &amp; Aims<\/jats:title>\n                    <jats:p>Vibration\u2010controlled transient elastography (VCTE) predicts liver\u2010related events (LREs), but how serial liver stiffness (LS) changes should be translated into clinical risk\u2014whether by their magnitude, direction or movement across established thresholds\u2014remains uncertain. We tested whether a threshold\u2010defined trajectory framework anchored at the Baveno VII 10\u2009kPa criterion would stratify LRE risk across chronic liver disease aetiologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      From the retrospective V\u2010LINK registry (2006\u20132020), 6313 event\u2010free patients with baseline and 1\u2010year LS were stratified by the 10\u2009kPa threshold into Stable Low, Improved, Worsened or Persistent High trajectories. A 3\u2010year landmark (LM3) subset (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091617) enabled trajectory reassessment over time. Cox models estimated adjusted hazard ratios (HRs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During a median follow\u2010up of 5.5\u2009years, 472 LREs occurred. Compared with Stable Low, adjusted HRs were 1.5 (95% confidence interval [CI], 1.1\u20132.2) for Improved, 2.5 (1.5\u20134.3) for Worsened and 4.1 (3.1\u20135.5) for Persistent High, with 3\u2010year risks of 1.2%, 3.2%, 3.8%, and 15.0%. Persistent High (14.4% of the cohort) accounted for 61.9% of LREs; 65.7% showed a numerical decrease in LS yet remained \u2265\u200910\u2009kPa. By aetiology, the HR for Persistent High was 6.4 (4.0\u201310.2) in non\u2010viral aetiologies versus 2.6 (1.8\u20133.8) in viral aetiologies (\n                      <jats:italic>p<\/jats:italic>\n                      for interaction &lt;\u20090.001). At LM3, the trajectory\u2010based risk gradient was preserved (Persistent High HR, 3.5; 95% CI, 2.2\u20135.5).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Threshold\u2010defined LS trajectories identified a small subgroup concentrating most LRE risk, with the largest gradient in non\u2010viral aetiologies. Persistent threshold elevation was the most robust prognostic signal, supporting serial LS monitoring pending external validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70819","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:59:11Z","timestamp":1785286751000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Threshold\u2010Defined Liver Stiffness Trajectories and Liver\u2010Related Event Risk in Chronic Liver Disease: A Cohort Study"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2471-3385","authenticated-orcid":false,"given":"Dong Yun","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Institute of Gastroenterology Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Yonsei Liver Center Severance Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2371-0967","authenticated-orcid":false,"given":"Jae Seung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Institute of Gastroenterology Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Yonsei Liver Center Severance Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3552-3560","authenticated-orcid":false,"given":"Hye Won","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Institute of Gastroenterology Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Yonsei Liver Center Severance Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5381-230X","authenticated-orcid":false,"given":"Mi Na","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Institute of Gastroenterology Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Yonsei Liver Center Severance Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5363-2496","authenticated-orcid":false,"given":"Beom Kyung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Institute of Gastroenterology Yonsei University College of Medicine  Seoul Republic of Korea"},{"name":"Yonsei Liver Center Severance Hospital  Seoul 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