A retrospective study on the relationship between fibrosis‑4 index and all‑cause mortality in patients with acute myocardial infarction

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.