Key result
FIB-5 outperforms FIB-4 for predicting MACE in young STEMI patients undergoing primary PCI.
Why the study?
The comparative prognostic value of FIB-4 and FIB-5 indices in STEMI patients undergoing primary PCI was unclear.
Does the FIB-5 index improve prognostic prediction of MACEs compared to the FIB-4 index in STEMI patients undergoing primary PCI?
Cohort (n=851)
Does the FIB-5 index improve prognostic prediction of MACEs compared to the FIB-4 index in STEMI patients undergoing primary PCI?
The FIB-5 index is a useful independent predictor of MACEs in STEMI patients undergoing primary PCI, showing superior prognostic performance to FIB-4 in patients under 65.
FIB-5 may refine MACE risk stratification in younger STEMI patients; leaves open prospective validation versus FIB-4 before clinical use.
This study aimed to compare the prognostic value of the liver fibrosis-4 (FIB-4) index with the fibrosis-5 (FIB-5) index in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. A total of 851 consecutive patients were included retrospectively. The association between FIB-4, FIB-5 and major adverse cardiac events (MACEs) was analyzed. The receiver operating characteristic (ROC) curve analyses were performed to compare the predictive performance of FIB-4 and FIB-5. ROC curves were also compared for all patients, as well as subgroups aged < 65 and ≥ 65 years, to evaluate the prognostic power of both indices. The mean age was 63.9 ± 10 years, and 76.0% of the patients were male. The mean follow-up duration was 39.8 ± 18.7. FIB-5 level was significantly lower in patients who experienced MACEs compared to those who did not. In pairwise analyses, FIB-5 demonstrated superior prognostic performance over FIB-4 in patients less than 65 years of age, whereas no significant differences were observed in the overall cohort or in patients aged 65 years or older. After adjustment in Cox regression analysis, FIB-5 remained an independent predictor of MACEs. Our study showed that FIB-5 index was better and useful predictor of MACEs in STEMI patients undergoing primary percutaneous coronary intervention regardless of age.
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Aydın et al. (2025) conducted a cohort in ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (n=851). FIB-5 index vs. FIB-4 index was evaluated on Major adverse cardiac events (MACEs). The FIB-5 index was an independent predictor of MACEs and demonstrated superior prognostic performance over FIB-4 in STEMI patients under 65 years of age undergoing primary PCI.
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