ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Clinical and Translational Cardiovascular Medicine
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1477206
Association between the fibrosis-4 and the risk of Left ventricular aneurysm formation in acute ST-segment elevation myocardial infarction
Provisionally accepted
- People's Hospital of Zhengzhou University, Zhengzhou, China
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BackgroundLeft ventricular aneurysm (LVA) is a common complication of acute myocardial infarction. This study aimed to investigate the predictive value of the fibrosis-4 (FIB-4) index for LVA formation in patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).MethodsWe recruited 1384 consecutive patients with STEMI. The clinical and laboratory data were compared between LVA group and non-LVA group. Multivariable logistic regression analysis was used to assess the independent risk factors of LVA formation. Restricted cubic spline (RCS) analysis was conducted to evaluate the nonlinear relationship between FIB-4 index and LVA formation. The predictive ability of the FIB-4 index and composite variable for LVA formation were assessed using receiver operating characteristic (ROC) curve.ResultsThe prevalence of LVA was 12.7%. A higher FIB-4 index was associated with an increased incidence of LVA (19% vs. 9.3%, P< 0.001). The FIB-4 index was also higher in the LVA group compared to the non-LVA group [1.8 (1.1-4.6) vs. 3.5 (1.4-8.1), P< 0.001]. Multivariable logistic regression analysis demonstrated that the FIB-4 index was independently associated with the risk of LVA (OR= 1.73, P= 0.004). RCS analysis revealed a nonlinear association between an increased FIB-4 index and a higher risk of LVA (Nonlinear P = 0.009). Additionally, the area under the ROC curve for the FIB-4 index in predicting LVA was 0.617. The composite variable comprising the FIB-4 index, left ventricular ejection fraction (LVEF), estimated glomerular filtration rate (eGFR), and left anterior descending artery (LAD) as culprit vessel significantly improved the predictive power (C statistic= 0.722). ConclusionAn increased FIB-4 index was positively associated with LVA formation in patients with acute STEMI who underwent primary PCI.
Keywords: Acute ST-segment elevation myocardial infarction, Primary percutaneous coronary intervention, Left ventricular aneurysm, fibrosis-4 index, risk
Received: 07 Aug 2024; Accepted: 28 May 2025.
Copyright: © 2025 Zhang, Yang and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kai Zhang, People's Hospital of Zhengzhou University, Zhengzhou, China
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