FIB-4 index and adverse outcomes of coronary artery disease: a systematic review and meta-analysis
- 1The Second Clinical Medical College, Southern Medical University, Guangzhou, Guangdong, China
- 2College of Mathematics and Statistics, Hainan University, Haikou, Hainan, China
- 3Supply Room, Jilin Jiangwan Trauma Hospital, Jilin City, Jilin Province, China
Abstract
This meta-analysis investigated the prognostic value of the Fibrosis-4 index (FIB-4) for adverse outcomes of coronary artery disease (CAD). The study aimed to systematically summarize and quantify the available evidence on the association between FIB-4 and adverse outcomes in CAD.
Four online databases (PubMed, Embase, Cochrane, and Web of Science) were searched to collect studies published up to May 21, 2025 exploring the association of the FIB-4 index with adverse outcomes in patients with CAD. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects model was applied to pool hazard ratios (HRs) with 95% confidence intervals (CIs).
We retrieved 5,809 publications in total. Twelve studies (31,817 CAD patients) were included after screening. All included studies scored ≥ 7 on the NOS, suggesting acceptable methodological quality. As a continuous variable, the FIB-4 index showed a significant positive association with adverse outcomes of CAD: all-cause mortality (ACM) (HR = 1.10, p for effect < 0.001) and cardiovascular death (HR = 1.13, p for effect < 0.001). As a categorical variable, the FIB-4 index exhibited a consistent positive association with adverse outcomes of CAD, although the results should be interpreted cautiously due to significant between-study heterogeneity: ACM (HR = 2.32, p for effect < 0.001), cardiovascular death (HR = 1.55, p for effect = 0.005), and major adverse cardiovascular events (MACEs, HR = 1.77, p for effect < 0.001). When the FIB-4 index was examined as a continuous variable, variability across disease populations was a source of heterogeneity.
This meta-analysis revealed a consistent positive association of the FIB-4 index with adverse outcomes of CAD. Further validation is required to establish its clinical utility.
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BibTeX
@article{gao2026fib4,
title = {{FIB-4 index and adverse outcomes of coronary artery disease: a systematic review and meta-analysis}},
author = {Haoxuan Gao and Lujia Chai and Xiaolin Meng},
journal = {Postepy w kardiologii interwencyjnej = Advances in interventional cardiology},
year = {2026},
month = sep,
doi = {10.5114/aic.2026.164916},
url = {https://europepmc.org/article/PMC/PMC13721071},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - FIB-4 index and adverse outcomes of coronary artery disease: a systematic review and meta-analysis
AU - Haoxuan Gao
AU - Lujia Chai
AU - Xiaolin Meng
PY - 2026
DA - 2026/09/01
JO - Postepy w kardiologii interwencyjnej = Advances in interventional cardiology
DO - 10.5114/aic.2026.164916
UR - https://europepmc.org/article/PMC/PMC13721071
AB - This meta-analysis investigated the prognostic value of the Fibrosis-4 index (FIB-4) for adverse outcomes of coronary artery disease (CAD). The study aimed to systematically summarize and quantify the available evidence on the association between FIB-4 and adverse outcomes in CAD. Four online databases (PubMed, Embase, Cochrane, and Web of Science) were searched to collect studies published up to May 21, 2025 exploring the association of the FIB-4 index with adverse outcomes in patients with CAD. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects model was applied to pool hazard ratios (HRs) with 95% confidence intervals (CIs). We retrieved 5,809 publications in total. Twelve studies (31,817 CAD patients) were included after screening. All included studies scored ≥ 7 on the NOS, suggesting acceptable methodological quality. As a continuous variable, the FIB-4 index showed a significant positive association with adverse outcomes of CAD: all-cause mortality (ACM) (HR = 1.10, p for effect < 0.001) and cardiovascular death (HR = 1.13, p for effect < 0.001). As a categorical variable, the FIB-4 index exhibited a consistent positive association with adverse outcomes of CAD, although the results should be interpreted cautiously due to significant between-study heterogeneity: ACM (HR = 2.32, p for effect < 0.001), cardiovascular death (HR = 1.55, p for effect = 0.005), and major adverse cardiovascular events (MACEs, HR = 1.77, p for effect < 0.001). When the FIB-4 index was examined as a continuous variable, variability across disease populations was a source of heterogeneity. This meta-analysis revealed a consistent positive association of the FIB-4 index with adverse outcomes of CAD. Further validation is required to establish its clinical utility.
SN - 1734-9338
SN - 1897-4295
ER -