Objective: The Fibrosis-4 (FIB-4) index, derived from routine laboratory measurements, is a noninvasive marker increasingly linked to cardiovascular risk. However, its prognostic value in ST-segment elevation myocardial infarction (STEMI), particularly for composite outcomes, remains unclear. The objective of this study was to determine the independent predictive value of the FIB-4 index for 1-year major adverse cardiovascular events (MACE) in patients with STEMI.
Methods: In this retrospective observational study, 1110 consecutive patients with STEMI treated with primary percutaneous coronary intervention were enrolled. The FIB-4 index was calculated on admission, and patients were grouped into tertiles. The primary outcome was 1-year MACE, a composite of all-cause death, reinfarction, and repeat revascularization. The association between FIB-4 index and outcomes was assessed using multivariable Cox regression and restricted cubic spline modeling.
Results: One-year MACE occurred in 19.1% of the cohort. Event rates increased progressively across the FIB-4 tertiles (log-rank P < .001), with early and persistent divergence in Kaplan-Meier survival curves. In multivariable analysis, the FIB-4 index was independently associated with 1-year MACE; each 1-unit increment conferred an increased risk (HR, 2.02; 95% CI, 1.89-2.16; P < .001). Restricted cubic spline analysis demonstrated a nonlinear relationship, with risk rising more steeply at low-to-intermediate values before tapering at higher levels.
Conclusions: Among patients with STEMI, the FIB-4 index was independently associated with adverse outcomes. Because it is simple and readily obtainable, it may add value to early risk assessment, although its incremental benefit over established risk models warrants further study.
M. F. Keten, Kadir Bıyıklı, B. Kültürsay et al.· The European Research Journa...· 0 citations
Aims: ST-segment elevation myocardial infarction (STEMI) remains a major cause of morbidity and mortality despite advances in reperfusion strategies. Systemic inflammation plays a key role in the pathophysiology of acute myocardial infarction and may influence long-term outcomes. The Aggregate Index of Systemic Inflammation (AISI) is a novel composite biomarker reflecting overall inflammatory burden. However, its prognostic value in STEMI patients undergoing primary percutaneous coronary intervention (PCI) remains insufficiently explored.Methods: In this retrospective, single-center cohort study, a total of 1.224 patients with STEMI who underwent primary PCI between November 2022 and April 2025 were included. AISI was calculated using admission hematological parameters, and patients were stratified into tertiles. The primary endpoint was major adverse cardiovascular events (MACE), defined as a composite of all-cause mortality, reinfarction, and repeat revascularization at 12 months. Cox proportional hazards models were used to identify independent predictors of MACE. Restricted cubic spline (RCS) analysis was performed to assess non-linear associations, and AISI was log-transformed for further modeling.Results: During a 12-month follow-up, the incidence of MACE increased significantly across AISI tertiles (14.2%, 16.7%, and 23.0%, respectively; p=0.003). In univariate analysis, higher AISI levels were associated with increased risk of MACE. In multivariable Cox regression analysis, AISI remained an independent predictor of MACE (HR: 1.001, 95% CI: 1.000-1.001, p=0.001). Restricted cubic spline (RCS) analysis demonstrated a non-linear association between AISI and MACE (p for non linearity
Ismail Balaban, Seda Tanyeri Uzel, B. Kültürsay et al.· Anatolian Current Medical Jo...· 0 citations