Fibrosis-5 index is a better predictor of adverse cardiac events than fibrosis-4 index
Key Takeaways
This retrospective, single-center study found that in patients hospitalized with heart failure (HF), a low fibrosis-5 index (FIB-5) was significantly associated with poor prognosis, irrespective of left ventricular ejection fraction (LVEF).
FIB-5 was a better predictor of cardiac death and HF rehospitalization than fibrosis-4 index (FIB-4).
Venous congestion and hypoperfusion, as a result of heart failure, have a negative impact on liver function. This can lead to abnormal liver function tests and an increase in liver fibrosis markers.
Why This Study Matters
Previous studies have shown that FIB4, which takes into account age, aspartate transaminase (AST), alanine aminotransferase (ALT), and platelet (PLT) count, is a predictor of death and rehospitalization in patients with HF. The FIB-5 index, which incorporates albumin, alkaline phosphatase, AST, ALT, and PLT count, was found to be better than FIB-4 for differentiation of liver fibrosis in patients with HBV and HCV infections. Based on these earlier studies, this study sought to compare the prognostic ability of FIB-4 and FIB-5 in patients with HF.
Study Design
This study included 906 patients who were hospitalized for heart failure. FIB-4 and FIB-5 scores were calculated for each patient upon discharge. Patients were classified into three groups based on their FIB-5 scores: low (n=303), middle (n=301), and high (n=302). The primary outcome of the study was a composite endpoint of cardiac death or rehospitalization for HF.
Results and Conclusions
The primary endpoint occurred in 51.5%, 36.5%, and 17.9% in the low, middle, and high FIB-5 groups, respectively. Low FIB-5 was significantly associated with cardiac death or rehospitalization for HF in patients with preserved and reduced LVEF. In comparison to FIB-4, investigators reported that FIB-5 was superior as a predictor of the primary endpoint.
Related Research
Consider these findings from similar research studies:
FIB-5 was superior to FIB-4 in differentiating liver fibrosis in patients with chronic HBV infections (Source).
FIB-4 index is a predictor of all-cause death and rehospitalization in patients with acute HF (Source).
Original Source
Maeda D, Kanzaki Y, Sakane K, et al. Prognostic value of the liver fibrosis marker fibrosis‐5 index in patients with acute heart failure. ESC Heart Failure. Published online February 3, 2022:ehf2.13829.