FIB-4, a surrogate marker of liver fibrosis, predicts mortality and adverse events after acute myocardial ınfarction.

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Internal and Emergency Medicine Pub Date : 2025-08-19 DOI:10.1007/s11739-025-04094-z

Mehmet Gorur, Salim Satar, Selen Acehan, Muge Gulen, Kadir Nigiz, Sarper Sevdımbas

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引用次数: 0

Abstract

The Fibrosis-4 (FIB-4) score is a simple, non-invasive index originally developed to assess liver fibrosis. Recently, it has gained attention as a potential prognostic marker in cardiovascular diseases. This study aimed to evaluate whether the FIB-4 score, independent of its role in liver assessment, can predict short-term mortality and major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI) undergoing coronary angiography (CAG) in the emergency department (ED). In this prospective observational study, 1017 patients diagnosed with AMI and treated with CAG between May 1, 2023, and February 29, 2024, were included. Patients were stratified into three groups based on FIB-4 score: low (< 1.45), intermediate (1.45-3.25), and high (> 3.25). Clinical and laboratory data, HEART scores, angiographic findings, in-hospital and 30-day outcomes were compared across groups. Patients with FIB-4 > 3.25 exhibited significantly higher rates of ST-elevation myocardial infarction (60.2%), hypertension (64%), diabetes mellitus (47.5%), atrial fibrillation (11%), and ventricular tachycardia (2.1%) (all p < 0.01). In-hospital mortality (14.4%), 30-day mortality (19.9%), and MACE (24.8%) were significantly elevated in this group (p < 0.001). Multivariate analysis identified FIB-4 > 3.25 (OR 3.816; p = 0.001), HEART score (OR 1.161; p = 0.013), and hemoglobin (OR 0.873; p = 0.038) as independent predictors of mortality. ROC analysis revealed moderate discriminative performance for FIB-4 (AUC: 0.693) and HEART score (AUC: 0.766). Elevated FIB-4 scores are independently associated with increased short-term mortality and adverse cardiovascular outcomes in AMI patients undergoing CAG. Beyond its traditional role in liver disease, the FIB-4 score may serve as a practical, non-invasive biomarker for early cardiovascular risk stratification in patients presenting to the ED with acute myocardial infarction.

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FIB-4是肝纤维化的替代标志物，可预测急性心肌梗死后的死亡率和不良事件ınfarction。

纤维化-4 （FIB-4）评分是一种简单、无创的指标，最初用于评估肝纤维化。最近，它作为一种潜在的心血管疾病预后标志物而受到关注。本研究旨在评估FIB-4评分在独立于肝脏评估中的作用下，是否可以预测急诊科（ED）接受冠状动脉造影（CAG）的急性心肌梗死（AMI）患者的短期死亡率和主要不良心血管事件（MACE）。在这项前瞻性观察性研究中，2023年5月1日至2024年2月29日期间，1017名诊断为AMI并接受CAG治疗的患者被纳入研究。根据FIB-4评分将患者分为三组：低（3.25）。临床和实验室数据、心脏评分、血管造影结果、住院和30天结果在各组间进行比较。FIB-4 > 3.25患者的st段抬高型心肌梗死（60.2%）、高血压（64%）、糖尿病（47.5%）、房颤（11%）和室性心动过速（2.1%）(均p 3.25 （OR 3.816; p = 0.001）、HEART评分（OR 1.161; p = 0.013）和血红蛋白（OR 0.873; p = 0.038）是死亡率的独立预测因子。ROC分析显示FIB-4 （AUC: 0.693）和HEART评分（AUC: 0.766）的判别性能中等。在行CAG的AMI患者中，FIB-4评分升高与短期死亡率和不良心血管结局的增加独立相关。除了在肝脏疾病中的传统作用外，FIB-4评分可以作为一种实用的、无创的生物标志物，用于急性心肌梗死患者的早期心血管风险分层。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Internal and Emergency Medicine 医学-医学：内科

CiteScore

7.20

自引率

4.30%

发文量

258

审稿时长

6-12 weeks

期刊介绍： Internal and Emergency Medicine (IEM) is an independent, international, English-language, peer-reviewed journal designed for internists and emergency physicians. IEM publishes a variety of manuscript types including Original investigations, Review articles, Letters to the Editor, Editorials and Commentaries. Occasionally IEM accepts unsolicited Reviews, Commentaries or Editorials. The journal is divided into three sections, i.e., Internal Medicine, Emergency Medicine and Clinical Evidence and Health Technology Assessment, with three separate editorial boards. In the Internal Medicine section, invited Case records and Physical examinations, devoted to underlining the role of a clinical approach in selected clinical cases, are also published. The Emergency Medicine section will include a Morbidity and Mortality Report and an Airway Forum concerning the management of difficult airway problems. As far as Critical Care is becoming an integral part of Emergency Medicine, a new sub-section will report the literature that concerns the interface not only for the care of the critical patient in the Emergency Department, but also in the Intensive Care Unit. Finally, in the Clinical Evidence and Health Technology Assessment section brief discussions of topics of evidence-based medicine (Cochrane’s corner) and Research updates are published. IEM encourages letters of rebuttal and criticism of published articles. Topics of interest include all subjects that relate to the science and practice of Internal and Emergency Medicine.