Department of Cardiology, China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Department of Cardiology, Beijing University of Chinese Medicine School of Traditional Chinese Medicine, Beijing, China.
Angiology. 2024 Mar;75(3):219-230. doi: 10.1177/00033197231197230. Epub 2023 Sep 2.
Liver fibrosis scores have been demonstrated to be associated with poor prognosis after percutaneous coronary intervention (PCI). However, no studies have compared the prognostic value of these scores in acute myocardial infarction (AMI) patients with and without diabetes. We retrospectively enrolled 1576 AMI patients who underwent PCI. There were 177 all-cause deaths and 111 cardiac deaths during follow-up (median 3.8 years). The non-alcoholic fatty liver disease fibrosis score (NFS) showed a better prognostic value than the fibrosis-8 (FIB-8) score (Harrell's C-index: 0.703 vs 0.671, = .014) and the fibrosis-4 (FIB-4) score (Harrell's C-index: 0.703 vs 0.648, < .001) in the overall population. In the time-dependent receiver operating characteristic analysis, the NFS also had the highest area under the curve across all time points. Consistent results were observed in diabetic and non-diabetic populations. Adding the NFS to traditional cardiovascular risk factors significantly improved the prediction both for all-cause mortality (Harrell's C-index: 0.806 vs 0.771, < .001) and cardiac death (Harrell's C-index: 0.800 vs 0.771, = .014). The NFS showed a better prognostic value than the FIB-8 score and the FIB-4 score in patients with AMI undergoing PCI, which might be preferable for estimating the risk of mortality regardless of the presence or absence of diabetes.
肝纤维化评分与经皮冠状动脉介入治疗（PCI）后的不良预后相关。然而，尚无研究比较这些评分在合并和不合并糖尿病的急性心肌梗死（AMI）患者中的预后价值。我们回顾性纳入了 1576 例行 PCI 的 AMI 患者。随访期间（中位时间为 3.8 年）共有 177 例全因死亡和 111 例心脏性死亡。非酒精性脂肪性肝病纤维化评分（NFS）比纤维化-8 评分（FIB-8）（Harrell's C 指数：0.703 比 0.671，.014）和纤维化-4 评分（FIB-4）（Harrell's C 指数：0.703 比 0.648， <.001）具有更好的预后价值。在时间依赖性接受者操作特征分析中，NFS 在所有时间点的曲线下面积也最高。在糖尿病和非糖尿病患者中均观察到一致的结果。将 NFS 添加到传统心血管危险因素中可显著改善全因死亡率（Harrell's C 指数：0.806 比 0.771， <.001）和心脏性死亡（Harrell's C 指数：0.800 比 0.771， =.014）的预测。NFS 在接受 PCI 的 AMI 患者中比 FIB-8 评分和 FIB-4 评分具有更好的预后价值，无论是否存在糖尿病，它可能更适合估计死亡率风险。
