Diabetes research and clinical practice · 2026
Liver fibrosis scores predict cardiovascular outcomes in myocardial infarction and non-obstructive coronary arteries patients with and without diabetes or prediabetes.
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Abdu Fuad A, Shi Tingting, Liu Lu, Alifu Jiasuer, Mohammed Abdul-Quddus, Yin Guoqing, Zhang Wen, Zhu Guofu, Che Wenliang
Аннотация
AIMS: We aimed to investigate the association between liver fibrosis scores (LFS) and major adverse cardiovascular events (MACE) in patients with myocardial infarction and non-obstructive coronary arteries (MINOCA), particularly in those with and without diabetes (DM) or prediabetes (pre-DM).
METHODS: Consecutive MINOCA patients were enrolled, and LFS were assessed using the fibrosis-4 index (FIB-4) and nonalcoholic fatty liver disease fibrosis score (NFS). High LFS were defined as FIB-4 ≥ 2.67 or NFS ≥ 0.676. Kaplan-Meier, restricted cubic spline (RCS) analysis, and Cox regression were used to assess MACE risk.
RESULTS: Among 406 MINOCA patients (mean age 63.7 years; 211 men), 271 had DM/pre-DM. Of these, 38.9% had high FIB-4, and 28.3% had high NFS. Over 32 months, high LFS predicted higher MACE rates (log-rank p < 0.05), particularly in patients with DM or pre-DM. RCS analysis showed a linear association between FIB-4 and MACE and a nonlinear association for NFS. Fully adjusted Cox models revealed that FIB-4 ≥ 2.67 or NFS ≥ 0.676 were independently associated with an increased risk of MACE in DM/pre-DM patients, but not in non-DM/pre-DM.
CONCLUSION: Elevated LFS predicts a higher risk of MACE in MINOCA, especially in patients with DM/pre-DM, and may aid in risk stratification.
METHODS: Consecutive MINOCA patients were enrolled, and LFS were assessed using the fibrosis-4 index (FIB-4) and nonalcoholic fatty liver disease fibrosis score (NFS). High LFS were defined as FIB-4 ≥ 2.67 or NFS ≥ 0.676. Kaplan-Meier, restricted cubic spline (RCS) analysis, and Cox regression were used to assess MACE risk.
RESULTS: Among 406 MINOCA patients (mean age 63.7 years; 211 men), 271 had DM/pre-DM. Of these, 38.9% had high FIB-4, and 28.3% had high NFS. Over 32 months, high LFS predicted higher MACE rates (log-rank p < 0.05), particularly in patients with DM or pre-DM. RCS analysis showed a linear association between FIB-4 and MACE and a nonlinear association for NFS. Fully adjusted Cox models revealed that FIB-4 ≥ 2.67 or NFS ≥ 0.676 were independently associated with an increased risk of MACE in DM/pre-DM patients, but not in non-DM/pre-DM.
CONCLUSION: Elevated LFS predicts a higher risk of MACE in MINOCA, especially in patients with DM/pre-DM, and may aid in risk stratification.