Comparative prognostic performance of the FIB-4 index versus SYNTAX and GRACE scores in predicting major cardiovascular events in acute coronary syndrome
Yükleniyor...
Tarih
2025
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Termedia Publishing House Ltd.
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Introduction: The Fibrosis-4 (FIB-4) index, a non-invasive marker of liver fibrosis originally developed for non-alcoholic fatty liver disease (NAFLD), has gained attention for its prognostic value in cardiovascular disease. Aim: Given the shared metabolic risk between NAFLD and acute coronary syndrome (ACS), this study aimed to evaluate the association between FIB-4 and major adverse cardiovascular events (MACE) in patients with ACS, in comparison with conventional risk scores. Material and methods: This is an observational cohort study included 941 patients hospitalized with ACS between 2017 and 2021. Patients were classified into three FIB-4 categories: low, < 1.45; intermediate, 1.45–3.25; and high, ≥ 3.25. Clinical, laboratory, angiographic, and echocardiographic data were collected. MACE incidence was evaluated over a median follow-up of 67.5 months. Cox regression and receiver operating characteristic (ROC) analyses were performed. Results: MACE occurred in 37.9% of patients in the high FIB-4 group, compared to 28.7% and 29.2% in the low and intermediate groups, respectively (p = 0.046). FIB-4 was an independent predictor of MACE (hazard ratio [HR]: 1.547; 95% CI: 1.169–2.046; p = 0.002). ROC analysis demonstrated superior prognostic accuracy for FIB-4 (area under the ROC curve: 0.693) over SYNTAX (0.609) and GRACE (0.552) scores. A Kaplan-Meier analysis showed significantly lower survival in the high FIB-4 group (p = 0.007). Conclusions: The FIB-4 index is a robust, accessible predictor of adverse cardiovascular outcomes in ACS and may enhance conventional risk stratification strategies by integrating systemic metabolic burden into cardiovascular risk assessment.
Açıklama
Anahtar Kelimeler
acute coronary syndrome, coronary artery disease, fibrosis, non-alcoholic fatty liver disease, risk
Kaynak
Postepy w Kardiologii Interwencyjnej
WoS Q Değeri
Q3
Scopus Q Değeri
Q3
Cilt
21
Sayı
3
Künye
Oksen, D., Gecit, M. H., Bulat, Z., Gokce, M. E., Bilgin, M. E., Balcioglu, S., ... & Oktay, V. (2025). Comparative prognostic performance of the FIB-4 index versus SYNTAX and GRACE scores in predicting major cardiovascular events in acute coronary syndrome. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 21(1), 332-340. 10.5114/aic.2025.153923
