Key result
Non-invasive hepatic fibrosis scores (APRI, FIB-4, FIB-5, FIB-6) did not independently predict in-hospital mortality (AUC 0.526-0.632) or cardiogenic shock (AUC 0.570-0.662) in ACS patients.
Why the study?
Hepatic fibrosis indices have emerged as potential prognostic markers in cardiovascular disease, motivating an evaluation of the distribution of APRI, FIB-4, FIB-5, and FIB-6 across ACS subtypes and their predictive value for in-hospital mortality and cardiogenic shock.
Do non-invasive hepatic fibrosis scores (APRI, FIB-4, FIB-5, FIB-6) predict in-hospital mortality and cardiogenic shock in patients with acute coronary syndrome?
Observational (n=760)
Do non-invasive hepatic fibrosis scores (APRI, FIB-4, FIB-5, FIB-6) predict in-hospital mortality and cardiogenic shock in patients with acute coronary syndrome?
Although hepatic fibrosis scores are significantly elevated in STEMI patients, they reflect acute myocardial injury severity rather than offering independent prognostic value for in-hospital mortality or cardiogenic shock in acute coronary syndrome.
Observed mortality in this cohort should not change practice; leaves open validation of fibrosis scores for STEMI risk stratification.
Hepatic fibrosis indices have emerged as potential prognostic markers in cardiovascular disease. This observational study included 760 consecutive patients with acute coronary syndrome (STEMI, NSTEMI, and unstable angina pectoris) admitted between March 2020 and May 2024 to evaluate the distribution of APRI, FIB-4, FIB-5, and FIB-6 across ACS subtypes and their predictive value for in-hospital mortality and cardiogenic shock. Fibrosis indices were calculated from admission laboratory values, and multivariate logistic regression and ROC curve analyses were performed. STEMI patients had significantly higher APRI (0.95±1.43 vs. 0.41±0.71 vs. 0.20±0.11), FIB-4 (3.68±4.03 vs. 1.98±2.17 vs. 1.17±0.52), and FIB-5 (5.16±1.08 vs. 4.66±0.84 vs. 4.38±0.43) than NSTEMI and unstable angina patients (all p<0.001). In-hospital mortality and cardiogenic shock occurred in 3.8% and 3.2% of patients, respectively. Cardiogenic shock, reduced left ventricular ejection fraction, and lower serum albumin independently predicted mortality, whereas older age independently predicted cardiogenic shock. None of the hepatic fibrosis indices independently predicted either outcome, and their discriminative performance was limited (AUC 0.526-0.632 for mortality and 0.570-0.662 for cardiogenic shock). These findings indicate that although hepatic fibrosis scores are elevated in STEMI, they primarily reflect the severity of acute myocardial injury rather than providing incremental prognostic value beyond established clinical predictors in patients with acute coronary syndrome.
No takes yet. Share an insight, caveat, or question.
Kaya et al. (2026) conducted an observational in Acute coronary syndrome (STEMI, NSTEMI, and unstable angina pectoris) (n=760). Non-invasive hepatic fibrosis indices (APRI, FIB-4, FIB-5, FIB-6) vs. Established clinical predictors and ACS subtypes (NSTEMI and unstable angina vs. STEMI) was evaluated on In-hospital mortality and cardiogenic shock (AUC 0.526-0.632 (mortality); AUC 0.570-0.662 (cardiogenic shock)). Non-invasive hepatic fibrosis scores (APRI, FIB-4, FIB-5, FIB-6) did not independently predict in-hospital mortality (AUC 0.526-0.632) or cardiogenic shock (AUC 0.570-0.662) in ACS patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: