Non-invasive scoring systems of liver fibrosis predict prognosis in the cohort with myocardial infarction
Abstract Patients with liver fibrosis and type 2 diabetes mellitus (T2DM) have an increased risk of cardiovascular events. However, long-term prognosis of liver fibrosis and T2DM after acute myocardial infarction (AMI) remain to be investigated. This study compared clinical characteristics and progn...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-07-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-025-12583-6 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849235472805527552 |
|---|---|
| author | Esther Wong Yiming Chen Gwyneth Kong Jobelle Chia Audrey Zhang Anurag Mehta Jayanth Jayabaskaran Bryan Chong Grace Cao Benjamin Nah Mark Yan-Yee Chan Mark Muthiah Poay-Huan Loh Mamas A. Mamas Nicholas WS Chew |
| author_facet | Esther Wong Yiming Chen Gwyneth Kong Jobelle Chia Audrey Zhang Anurag Mehta Jayanth Jayabaskaran Bryan Chong Grace Cao Benjamin Nah Mark Yan-Yee Chan Mark Muthiah Poay-Huan Loh Mamas A. Mamas Nicholas WS Chew |
| author_sort | Esther Wong |
| collection | DOAJ |
| description | Abstract Patients with liver fibrosis and type 2 diabetes mellitus (T2DM) have an increased risk of cardiovascular events. However, long-term prognosis of liver fibrosis and T2DM after acute myocardial infarction (AMI) remain to be investigated. This study compared clinical characteristics and prognosis of AMI patients with T2DM and evidence of liver fibrosis. Patients were stratified into low, intermediate and high-risk for fibrosis, using serum-based non-invasive tests (NITs): Fibrosis-4 Index (FIB-4), Aspartate Aminotransferase to Platelet Ratio Index (APRI) and Non-alcoholic Fatty Liver Disease Fibrosis Score (NFS). The primary outcome was all-cause mortality, Kaplan-Meier curves were constructed for 5-year all-cause mortality. Cox regression analysis was used to determine the independent predictors of mortality, adjusting for confounders. Out of 3287 AMI patients, 1547 were stratified as high-risk by any NIT (mean follow-up duration 2.7 ± 2.3 years). A dose-response relationship was found with increasing mortality risk for higher APRI and NFS scores. High-risk FIB-4 also predicted mortality significantly (adjusted HR [aHR] 1.791, 95% CI 1.436–2.235, p < 0.001). High-risk FIB-4 and APRI independently predicted mortality regardless of T2DM status, while NFS only predicted mortality in T2DM patients. Following AMI, individuals stratified by FIB-4, APRI, NFS as high-risk for liver fibrosis were associated with excess long-term mortality (aHR 1.780, 95% CI 1.442–2.196, p < 0.001). Hence, readily available NITs may be beneficial in risk prognostication of AMI patients. |
| format | Article |
| id | doaj-art-8fd6afc28c4045c0a7ea35a98b05c1ad |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-8fd6afc28c4045c0a7ea35a98b05c1ad2025-08-20T04:02:46ZengNature PortfolioScientific Reports2045-23222025-07-0115111310.1038/s41598-025-12583-6Non-invasive scoring systems of liver fibrosis predict prognosis in the cohort with myocardial infarctionEsther Wong0Yiming Chen1Gwyneth Kong2Jobelle Chia3Audrey Zhang4Anurag Mehta5Jayanth Jayabaskaran6Bryan Chong7Grace Cao8Benjamin Nah9Mark Yan-Yee Chan10Mark Muthiah11Poay-Huan Loh12Mamas A. Mamas13Nicholas WS Chew14Yong Loo Lin School of Medicine, National University of SingaporeYong Loo Lin School of Medicine, National University of SingaporeDepartment of Medicine, National University HospitalDepartment of Cardiology, National University Heart Centre, National University Health SystemDepartment of Medicine, National University HospitalVCU Health Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University School of MedicineYong Loo Lin School of Medicine, National University of SingaporeDepartment of Medicine, National University HospitalYong Loo Lin School of Medicine, National University of SingaporeDepartment of Medicine, National University HospitalDepartment of Cardiology, National University Heart Centre, National University Health SystemDivision of Gastroenterology and Hepatology, Department of Medicine, National University HospitalYong Loo Lin School of Medicine, National University of SingaporeInstitute of Population Health, University of ManchesterDepartment of Cardiology, National University Heart Centre, National University Health SystemAbstract Patients with liver fibrosis and type 2 diabetes mellitus (T2DM) have an increased risk of cardiovascular events. However, long-term prognosis of liver fibrosis and T2DM after acute myocardial infarction (AMI) remain to be investigated. This study compared clinical characteristics and prognosis of AMI patients with T2DM and evidence of liver fibrosis. Patients were stratified into low, intermediate and high-risk for fibrosis, using serum-based non-invasive tests (NITs): Fibrosis-4 Index (FIB-4), Aspartate Aminotransferase to Platelet Ratio Index (APRI) and Non-alcoholic Fatty Liver Disease Fibrosis Score (NFS). The primary outcome was all-cause mortality, Kaplan-Meier curves were constructed for 5-year all-cause mortality. Cox regression analysis was used to determine the independent predictors of mortality, adjusting for confounders. Out of 3287 AMI patients, 1547 were stratified as high-risk by any NIT (mean follow-up duration 2.7 ± 2.3 years). A dose-response relationship was found with increasing mortality risk for higher APRI and NFS scores. High-risk FIB-4 also predicted mortality significantly (adjusted HR [aHR] 1.791, 95% CI 1.436–2.235, p < 0.001). High-risk FIB-4 and APRI independently predicted mortality regardless of T2DM status, while NFS only predicted mortality in T2DM patients. Following AMI, individuals stratified by FIB-4, APRI, NFS as high-risk for liver fibrosis were associated with excess long-term mortality (aHR 1.780, 95% CI 1.442–2.196, p < 0.001). Hence, readily available NITs may be beneficial in risk prognostication of AMI patients.https://doi.org/10.1038/s41598-025-12583-6Metabolic dysfunction-associated steatotic liver diseaseNon-invasive testsFibrosis-4 indexAspartate aminotransferase to platelet ratio indexNon-alcoholic fatty liver disease fibrosis scoreAcute coronary syndrome |
| spellingShingle | Esther Wong Yiming Chen Gwyneth Kong Jobelle Chia Audrey Zhang Anurag Mehta Jayanth Jayabaskaran Bryan Chong Grace Cao Benjamin Nah Mark Yan-Yee Chan Mark Muthiah Poay-Huan Loh Mamas A. Mamas Nicholas WS Chew Non-invasive scoring systems of liver fibrosis predict prognosis in the cohort with myocardial infarction Scientific Reports Metabolic dysfunction-associated steatotic liver disease Non-invasive tests Fibrosis-4 index Aspartate aminotransferase to platelet ratio index Non-alcoholic fatty liver disease fibrosis score Acute coronary syndrome |
| title | Non-invasive scoring systems of liver fibrosis predict prognosis in the cohort with myocardial infarction |
| title_full | Non-invasive scoring systems of liver fibrosis predict prognosis in the cohort with myocardial infarction |
| title_fullStr | Non-invasive scoring systems of liver fibrosis predict prognosis in the cohort with myocardial infarction |
| title_full_unstemmed | Non-invasive scoring systems of liver fibrosis predict prognosis in the cohort with myocardial infarction |
| title_short | Non-invasive scoring systems of liver fibrosis predict prognosis in the cohort with myocardial infarction |
| title_sort | non invasive scoring systems of liver fibrosis predict prognosis in the cohort with myocardial infarction |
| topic | Metabolic dysfunction-associated steatotic liver disease Non-invasive tests Fibrosis-4 index Aspartate aminotransferase to platelet ratio index Non-alcoholic fatty liver disease fibrosis score Acute coronary syndrome |
| url | https://doi.org/10.1038/s41598-025-12583-6 |
| work_keys_str_mv | AT estherwong noninvasivescoringsystemsofliverfibrosispredictprognosisinthecohortwithmyocardialinfarction AT yimingchen noninvasivescoringsystemsofliverfibrosispredictprognosisinthecohortwithmyocardialinfarction AT gwynethkong noninvasivescoringsystemsofliverfibrosispredictprognosisinthecohortwithmyocardialinfarction AT jobellechia noninvasivescoringsystemsofliverfibrosispredictprognosisinthecohortwithmyocardialinfarction AT audreyzhang noninvasivescoringsystemsofliverfibrosispredictprognosisinthecohortwithmyocardialinfarction AT anuragmehta noninvasivescoringsystemsofliverfibrosispredictprognosisinthecohortwithmyocardialinfarction AT jayanthjayabaskaran noninvasivescoringsystemsofliverfibrosispredictprognosisinthecohortwithmyocardialinfarction AT bryanchong noninvasivescoringsystemsofliverfibrosispredictprognosisinthecohortwithmyocardialinfarction AT gracecao noninvasivescoringsystemsofliverfibrosispredictprognosisinthecohortwithmyocardialinfarction AT benjaminnah noninvasivescoringsystemsofliverfibrosispredictprognosisinthecohortwithmyocardialinfarction AT markyanyeechan noninvasivescoringsystemsofliverfibrosispredictprognosisinthecohortwithmyocardialinfarction AT markmuthiah noninvasivescoringsystemsofliverfibrosispredictprognosisinthecohortwithmyocardialinfarction AT poayhuanloh noninvasivescoringsystemsofliverfibrosispredictprognosisinthecohortwithmyocardialinfarction AT mamasamamas noninvasivescoringsystemsofliverfibrosispredictprognosisinthecohortwithmyocardialinfarction AT nicholaswschew noninvasivescoringsystemsofliverfibrosispredictprognosisinthecohortwithmyocardialinfarction |