Key result
NFS predicts mortality better than FIB-8 in AMI patients undergoing PCI.
Why the study?
Although liver fibrosis scores are linked to poor prognosis after PCI, no studies had compared their prognostic value in AMI patients with and without diabetes.
Does the non-alcoholic fatty liver disease fibrosis score (NFS) improve mortality risk prediction compared to FIB-8 and FIB-4 scores in AMI patients undergoing PCI?
Cohort (n=1,576)
Does the non-alcoholic fatty liver disease fibrosis score (NFS) improve mortality risk prediction compared to FIB-8 and FIB-4 scores in AMI patients undergoing PCI?
Absolute Event Rate: 0.703% vs 0.671%
p-value: p=.014
The NFS provides superior prognostic value compared to FIB-8 and FIB-4 scores for predicting mortality in AMI patients undergoing PCI, regardless of diabetes status.
NFS may refine mortality risk stratification post-PCI in AMI; hypothesis-generating and requires prospective validation before practice change.
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, P = .014) and the fibrosis-4 (FIB-4) score (Harrell’s C-index: 0.703 vs 0.648, P < .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, P < .001) and cardiac death (Harrell’s C-index: 0.800 vs 0.771, P = .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.
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He et al. (2023) conducted a cohort in Acute myocardial infarction (AMI) (n=1,576). Non-alcoholic fatty liver disease fibrosis score (NFS) vs. Fibrosis-8 (FIB-8) and fibrosis-4 (FIB-4) scores was evaluated on Prognostic value (Harrell's C-index) (p=.014). The non-alcoholic fatty liver disease fibrosis score (NFS) showed better prognostic value than the FIB-8 score (C-index 0.703 vs 0.671, P=0.014) for AMI patients undergoing PCI.
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