Cao Maolin, Li Tingming, Li Zhifeng, Gong Fang, Chen Zijun
Department of Cardiology, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, P.R. China.
Exp Ther Med. 2022 Aug 31;24(4):643. doi: 10.3892/etm.2022.11580. eCollection 2022 Oct.
The fibrosis-4 (FIB-4) index is a non-invasive score used to determine liver fibrosis. The present study aimed to assess the predictive ability of FIB-4 for all-cause mortality in patients with acute myocardial infarction (AMI). It retrospectively analyzed a total of 797 patients who were diagnosed with AMI. The patients were equally divided into three tertiles based on the values of the FIB-4 index scores: Group A (FIB-4 index <3.19; n=265), group B (3.19 ≤FIB-4 <8.14; n=267) and group C (FIB-4 index ≥8.14 group; n=265). Kaplan-Meier curves were used to analyze the incidence of all-cause mortality among the three groups. Multivariate Cox regression analysis was used to assess the association of risk of all-cause mortality in the patients. The Kaplan-Meier curves showed that the incidence of all-cause mortality was statistically significantly higher in group C than in groups A and B (P<0.001). After adjusting for confounding factors, multivariate Cox analysis demonstrated the risk of all-cause mortality in group C was significantly higher than in group A (hazard ratio: 2.898, 95% confidence interval: 1.069-7.857, P=0.037). In receiver-operating characteristics (ROC) analysis, an FIB-4 index of 6.647 and a Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score of 26.75 had sensitivities of 67.3 and 55.8% and specificities of 63 and 71.9%, respectively. Comparing the area under the ROC curve revealed no statistical differences between the FIB-4 index and SYNTAX score (0.654 vs. 0.661; P=0.864). Higher FIB-4 index were associated with increased risks of all-cause mortality among AMI patients. The FIB-4 index, a noninvasive and convenient tool, plays a potential role in the prognosis of AMI.
纤维化-4（FIB-4）指数是一种用于确定肝纤维化的非侵入性评分。本研究旨在评估FIB-4对急性心肌梗死（AMI）患者全因死亡率的预测能力。该研究回顾性分析了总共797例被诊断为AMI的患者。根据FIB-4指数评分将患者平均分为三个三分位数组：A组（FIB-4指数<3.19；n = 265）、B组（3.19≤FIB-4<8.14；n = 267）和C组（FIB-4指数≥8.14组；n = 265）。采用Kaplan-Meier曲线分析三组患者的全因死亡率发生率。采用多因素Cox回归分析评估患者全因死亡风险的相关性。Kaplan-Meier曲线显示，C组的全因死亡率发生率在统计学上显著高于A组和B组（P<0.001）。在调整混杂因素后，多因素Cox分析表明C组的全因死亡风险显著高于A组（风险比：2.898，95%置信区间：1.069 - 7.857，P = 0.037）。在受试者工作特征（ROC）分析中，FIB-4指数为6.647和紫杉醇药物洗脱支架与心脏外科手术协同作用（SYNTAX）评分为26.75时，敏感性分别为67.3%和55.8%，特异性分别为63%和71.9%。比较ROC曲线下面积发现，FIB-4指数和SYNTAX评分之间无统计学差异（0.654对0.661；P = 0.864）。较高的FIB-4指数与AMI患者全因死亡风险增加相关。FIB-4指数作为一种非侵入性且便捷的工具，在AMI的预后中发挥着潜在作用。
