A NEW study has revealed that simple blood tests used to assess liver health may hold crucial insights into survival outcomes following a heart attack. Acute myocardial infarction (AMI) is already a leading cause of death in developed nations, and cases are projected to triple by 2050. Traditional risk prediction tools like the GRACE score often fall short, especially for people with type 2 diabetes (T2DM). Researchers are now turning to non-invasive liver fibrosis tests to better assess risk in AMI patients.
The study examined three liver fibrosis scores, FIB-4, APRI, and NFS, all derived from routine blood test markers. These scores, widely used to detect liver scarring without the need for a biopsy, were found to be strong predictors of long-term survival after a heart attack, even in patients without known liver disease.
Key findings showed a clear, stepwise increase in risk of complications, including heart failure, stroke, and cardiac arrest, as liver fibrosis scores rose. Importantly, high-risk scores were predictive of death regardless of T2DM status for FIB-4 and APRI, but NFS only predicted poor outcomes in patients with T2DM. This highlights the need for personalised interpretation of these tests depending on diabetic status.
The study also emphasised the value of continuous risk scoring over fixed cut-offs, suggesting liver fibrosis behaves more like a spectrum than a simple yes/no diagnosis. These findings open new possibilities for enhancing cardiovascular risk models by including liver health metrics, a step toward truly personalised care.
Incorporating these liver indices could improve post-AMI risk assessments and guide long-term management, especially for individuals with overlapping metabolic conditions like T2DM and MASLD. The study provides strong evidence that the heart-liver connection may be more significant than previously thought.
Reference
Wong E et al. Non-invasive scoring systems of liver fibrosis predict prognosis in the cohort with myocardial infarction. Sci Rep. 2025;15(1):26499.
