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首页> 外文期刊>Progress in Artificial Intelligence >Impact of the Fibrosis-4 Index on Risk Stratification of Cardiovascular Events and Mortality in Patients with Atrial Fibrillation: Findings from a Japanese Multicenter Registry
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Impact of the Fibrosis-4 Index on Risk Stratification of Cardiovascular Events and Mortality in Patients with Atrial Fibrillation: Findings from a Japanese Multicenter Registry

机译:纤维化-4纤维化-4指数对心房颤动患者心血管事件和死亡率风险分层的影响:日本多中心登记处的研究结果

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Background: Liver diseases drive the development and progression of atrial fibrillation (AF). The Fibrosis-4 (FIB4) index is a non-invasive scoring method for detecting liver fibrosis, but the prognostic impact of using it for AF patients is still unknown. Herein, we evaluated using the FIB4 index as a risk assessment tool for cardiovascular events and mortality in patients with AF. Methods: We performed a post-hoc analysis of a prospective, observational multicenter study. A total of 3067 patients enrolled in a multicenter Japanese registry were grouped as first tertile (FIB4 index < 1.75, n = 1022), second tertile (1.75 <= FIB4 index < 2.51, n = 1022), and third tertile (FIB4 index >= 2.51, n = 1023). Results: The third tertile had statistically significant results: older age, lower body mass index, increased heart failure prevalence, and lower clearances of hemoglobin and creatinine (all p < 0.05). During the follow-up period, incidences of major bleeding, cardiovascular events, and all-cause mortality were significantly higher for the third tertile (all p < 0.05). After multivariate adjustment, the third tertile associated independently with cardiovascular events (HR 1.72; 95% CI 1.31-2.25) and all-cause mortality (HR 1.43; 95% CI 1.06-1.95). Adding the FIB4 index to a baseline model with CHA(2)DS(2)-VASc score improved the prediction of cardiovascular events and all-cause mortality, as shown by the significant increase in the C-statistic (all p < 0.05), net reclassification improvement (all p < 0.001), and integrated discrimination improvement (all p < 0.001). A FIB4 index >= 2.51 most strongly associated with cardiovascular events and all-cause mortality in AF patients with high CHADS(2) scores (all p < 0.001). Conclusions: The FIB4 index is independently associated with risks of cardiovascular events and all-cause mortality in AF patients.
机译:背景:肝脏疾病推动心房颤动的发展和进展(AF)。纤维化-4(FIB4)指数是一种用于检测肝纤维化的非侵入性评分方法,但使用它用于AF患者的预后影响仍然未知。在此,我们使用FIB4指数评估为用于AF的患者心血管事件和死亡率的风险评估工具。方法:我们对前瞻性的观察多中心研究进行了HOC分析。共有3067名患者参加多中心日本登记处的患者被分组为第一泰利尔(FIB4指数<1.75,N = 1022),第二张力(1.75 <= FIB4索引<2.51,N = 1022)和第三张力(FIB4索引> = 2.51,n = 1023)。结果:第三届TERTILE具有统计学显着的结果:较旧的年龄,低体重指数,血红蛋白和肌酐的较低间隙(所有P <0.05)。在后续期间,第三次菌利梭菌的主要出血,心血管事件和全因死亡率的发生率(所有P <0.05)显着高。多变量调整后,第三型泰利物与心血管事件独立相关(HR 1.72; 95%CI 1.31-25)和全因死亡率(HR 1.43; 95%CI 1.06-1.95)。将FIB4索引添加到具有CHA(2)DS(2)-VASC评分的基线模型改善了心血管事件的预测和全因死亡率,如C统计的显着增加所示(所有P <0.05)所示,净重新分类改善(所有P <0.001),并综合歧视改善(所有P <0.001)。 FIB4指数> = 2.51与心血管事件最强烈相关,AF患者的心血管事件和全导致死亡率高(2)分数(所有P <0.001)。结论:FIB4指数与AF患者的心血管事件和全导致死亡率的风险独立相关。

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