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Non-invasive scoring systems of liver fibrosis predict prognosis in the cohort with myocardial infarction

  • 0Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Scientific Reports +

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July 21, 2025

|

July 21, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Patients with acute myocardial infarction (AMI) and liver fibrosis face higher long-term mortality risks. Non-invasive liver fibrosis tests like FIB-4 and APRI can help predict survival, regardless of type 2 diabetes mellitus (T2DM) status.

Area Of Science

  • Cardiology
  • Hepatology
  • Diabetology

Background

  • Patients with type 2 diabetes mellitus (T2DM) and liver fibrosis have elevated cardiovascular event risks.
  • The long-term prognosis of liver fibrosis and T2DM following acute myocardial infarction (AMI) requires further investigation.

Purpose Of The Study

  • To compare clinical characteristics and prognosis of AMI patients with T2DM and evidence of liver fibrosis.
  • To evaluate the utility of non-invasive liver fibrosis tests in predicting long-term mortality after AMI.

Main Methods

  • Stratified 3287 AMI patients into low, intermediate, and high-risk groups for fibrosis using Fibrosis-4 Index (FIB-4), Aspartate Aminotransferase to Platelet Ratio Index (APRI), and Non-alcoholic Fatty Liver Disease Fibrosis Score (NFS).
  • Assessed 5-year all-cause mortality using Kaplan-Meier curves and Cox regression analysis, adjusting for confounders.
  • Analyzed mortality prediction based on fibrosis risk scores and T2DM status.

Main Results

  • 1547 patients (47%) were stratified as high-risk by at least one non-invasive test.
  • Higher APRI and NFS scores showed a dose-response relationship with increased mortality risk.
  • High-risk FIB-4 and APRI independently predicted mortality irrespective of T2DM status; NFS predicted mortality only in T2DM patients.
  • Overall, high-risk fibrosis stratification was associated with excess long-term mortality (aHR 1.780, p < 0.001).

Conclusions

  • Non-invasive liver fibrosis tests (FIB-4, APRI, NFS) are valuable tools for risk prognostication in AMI patients.
  • FIB-4 and APRI demonstrate independent predictive value for mortality post-AMI, even in patients without T2DM.
  • Liver fibrosis assessment can enhance long-term mortality risk stratification in AMI survivors, particularly those with T2DM.

Keywords:

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