The prognostic value of liver function assessment tools in patients with ST-segment elevation myocardial infarction

Liver dysfunction was associated with poor outcomes in patients with ST-segment elevation myocardial infarction(STEMI).However,the optimal methods for assessing the liver function was unclear.This study was to compare the predictive value of the different liver function assessment tools for in-hospital and oneyear adverse events in STEMI patients undergoing percutaneous coronary intervention(PCI).Methods A total of 1157 patients with STEMI undergoing PCI were enrolled from January 2012 to December 2015.The model for end-stage liver disease excluding international normalized ratio(MELD-XI)and albumin-bilirubin(ALBI)score were calculated at admission.The discrimination and calibration of these two scores for in-hospital and oneyear adverse events were compared.Results The in-hospital mortality was 4.0%.Both MELD-XI[area under the curve(AUC)=0.768,95%confidence interval(CI):0.691-0.845,P<0.001]and ALBI score(AUC=0.682,95%CI:0.602-0.761,P<0.001)had excellent discrimination for in-hospital death.The calibration for in-hospital death was good in MELD-XI(Hosmer-Lemeshow chi-square=7.2,P=0.520),but not good in ALBI score(Hosmer-Lemeshow chi-square=13.8,P=0.087).In addition,the predictive power of MELD-XI for in-hospital death was better than ALBI score(AUC:0.768 vs.0.682,P=0.037).1108(95.8%)patients completed one-year followup.Kaplan-Meier analysis showed that patients with a high MELD-XI score had high-risk of one-year mortality(Log-rank test:54.8,P<0.001).Conclusions As the method for assessing the liver function,MELD-XI was better than ALBI score in predicting the in-hospital and one-year adverse events in STEMI patients,which could be considered as a risk assessment tool.