PMID- 35951109
OWN - NLM
STAT- MEDLINE
DCOM- 20230207
LR  - 20230628
IS  - 1861-0692 (Electronic)
IS  - 1861-0684 (Print)
IS  - 1861-0684 (Linking)
VI  - 112
IP  - 2
DP  - 2023 Feb
TI  - Relationship between non-invasively detected liver fibrosis and in-hospital 
      outcomes in patients with acute coronary syndrome undergoing PCI.
PG  - 236-246
LID - 10.1007/s00392-022-02078-z [doi]
AB  - BACKGROUND: Patients with acute coronary syndrome (ACS) undergoing percutaneous 
      coronary intervention (PCI) still experience a high rate of in-hospital 
      complications. Liver fibrosis (LF) is a risk factor for mortality in the general 
      population. We investigated whether the presence of LF detected by the validated 
      fibrosis 4 (FIB-4) score may indicate ACS patients at higher risk of poor 
      outcome. METHODS: In the prospective ongoing REAl-world observationaL rEgistry of 
      Acute Coronary Syndrome (REALE-ACS), LF was defined by a FIB-4 score > 3.25. We 
      repeated the analysis using an APRI score > 0.7. The primary endpoint was 
      in-hospital adverse events (AEs) including a composite of in-hospital cardiogenic 
      shock, PEA/asystole, acute pulmonary edema and death. RESULTS: A total of 469 
      consecutive ACS consecutive patients were enrolled. Overall, 21.1% of patients 
      had a FIB-4 score > 3.25. Patients with LF were older, less frequently on P2Y12 
      inhibitors (p = 0.021) and admitted with higher serum levels of white blood cells 
      (p < 0.001), neutrophils to lymphocytes ratio (p < 0.001), C-reactive protein 
      (p = 0.013), hs-TnT (p < 0.001), creatine-kinase MB (p < 0.001), D-Dimer levels 
      (p < 0.001). STEMI presentation and higher Killip class/GRACE score were more 
      common in the LF group (p < 0.001). 71 patients experienced 110 AEs. At the 
      multivariate analysis including clinical and laboratory risk factors, 
      FIB-4 > 3.25 (OR 3.1, 95%CI 1.4-6.9), admission left ventricular ejection 
      fraction% below median (OR 9.2, 95%CI 3.9-21.7) and Killip class >/= II (OR 6.3, 
      95%CI 2.2-18.4) were the strongest independent predictors of in-hospital AEs. 
      Similar results were obtained using the APRI score. CONCLUSION: LF detected by 
      FIB-4 score > 3.25 was associated with more severe ACS presentation and worse 
      in-hospital AEs irrespective of clinical and laboratory variables.
CI  - (c) 2022. The Author(s).
FAU - Biccire, Flavio Giuseppe
AU  - Biccire FG
AD  - Department of General and Specialized Surgery "Paride Stefanini, Sapienza 
      University of Rome, Rome, Italy.
FAU - Barilla, Francesco
AU  - Barilla F
AD  - Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
FAU - Sammartini, Emanuele
AU  - Sammartini E
AD  - Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, 
      Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
FAU - Dacierno, Edoardo Maria
AU  - Dacierno EM
AD  - Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, 
      Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
FAU - Tanzilli, Gaetano
AU  - Tanzilli G
AD  - Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, 
      Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
FAU - Pastori, Daniele
AU  - Pastori D
AUID- ORCID: 0000-0001-6357-5213
AD  - Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, 
      Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy. 
      daniele.pastori@uniroma1.it.
LA  - eng
PT  - Journal Article
DEP - 20220811
PL  - Germany
TA  - Clin Res Cardiol
JT  - Clinical research in cardiology : official journal of the German Cardiac Society
JID - 101264123
SB  - IM
CIN - Clin Res Cardiol. 2023 Jul;112(7):1003-1004. PMID: 37118637
MH  - Humans
MH  - *Acute Coronary Syndrome/diagnosis/surgery/etiology
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - *Myocardial Infarction/epidemiology
MH  - Prospective Studies
MH  - Stroke Volume
MH  - Ventricular Function, Left
MH  - Risk Factors
MH  - Liver Cirrhosis/complications/diagnosis
MH  - Hospitals
MH  - Registries
MH  - Hospital Mortality
MH  - Treatment Outcome
MH  - Risk Assessment
PMC - PMC9898425
OTO - NOTNLM
OT  - Acute coronary syndrome
OT  - Adverse events
OT  - Cardiogenic shock
OT  - Liver fibrosis
OT  - Myocardial infarction
COIS- All authors declare that they have no competing interests.
EDAT- 2022/08/12 06:00
MHDA- 2023/02/08 06:00
PMCR- 2022/08/11
CRDT- 2022/08/11 11:17
PHST- 2022/04/14 00:00 [received]
PHST- 2022/07/29 00:00 [accepted]
PHST- 2022/08/12 06:00 [pubmed]
PHST- 2023/02/08 06:00 [medline]
PHST- 2022/08/11 11:17 [entrez]
PHST- 2022/08/11 00:00 [pmc-release]
AID - 10.1007/s00392-022-02078-z [pii]
AID - 2078 [pii]
AID - 10.1007/s00392-022-02078-z [doi]
PST - ppublish
SO  - Clin Res Cardiol. 2023 Feb;112(2):236-246. doi: 10.1007/s00392-022-02078-z. Epub 
      2022 Aug 11.