Impact of predictive value of Fibrosis-4 index in patients hospitalized for acute heart failure

Shibata, Naoki; Kondo, Toru; Kazama, S.; Kimura, Yuki; Oishi, Hideo; Arao, Yoshihito; Kato, Hiroo; Yamaguchi, Shogo; Kuwayama, Tasuku; Hiraiwa, Hiroaki; Morimoto, Ryo; Okumura, Takahiro; Sumi, Takuya; Sawamura, Akinori; Shimizu, Kiyokazu; Murohara, Toyoaki

doi:10.1016/j.ijcard.2020.09.056

Cited by 27 publications

(23 citation statements)

References 42 publications

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“…This is the first study to investigate the fibrosis-4 index in patients with aortic stenosis. The median value was 2.8, which is almost comparable with other previous studies including heart failure cohorts [6,7]. Of note, in a study by Takae and colleagues, a higher fibrosis-4 index was associated with clinical outcomes in patients with diastolic heart failure but not in patients with systolic heart failure [7].…”

Section: Fibrosis-4 Index and Aortic Stenosissupporting

confidence: 85%

“…The fibrosis-4 index was originally introduced to predict the progression of hepatic fibrosis in patients with hepatic diseases [5]. The use of this index has recently expanded to assess the degree of right-sided volume overload and to predict prognosis in patients with acute/chronic heart failure [6][7][8], pulmonary hypertension due to left heart disease [9], and atrial fibrillation [10]. The fibrosis-4 index would reflect hepatic injury via systemic congestion, mostly due to hepatic congestion, and hypo-perfusion due to low cardiac output.…”

Section: Fibrosis-4 Index and Aortic Stenosismentioning

confidence: 99%

“…This index is calculated using four standard clinical parameters associated with hepatic function: {[glutamic oxaloacetic transaminase (IU/L)] × [age (years)]}/{[platelet counts (×10 9 /L) × [glutamic pyruvic transaminase (IU/L)] 1/2 } [5]. Recently, the fibrosis-4 index has been used in patients with chronic heart failure [6], where an elevated fibrosis-4 index may be associated with systemic congestion and worse clinical prognosis [7].…”

Section: Introductionmentioning

confidence: 99%

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Implications of Elevated Fibrosis-4 Index in Patients Receiving Trans-Catheter Aortic Valve Replacement

Imamura

Narang

Onoda

et al. 2021

JCM

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Background: The prognostic implication of the fibrosis-4 index, which represents the degree of hepatic injury, on patients receiving trans-catheter aortic valve replacement (TAVR) remains unknown. Methods: Patients who underwent TAVR to treat severe aortic stenosis at our institute between 2015 and 2020 were included in this retrospective study and followed for 2 years from the index discharge. The impact of the fibrosis-4 index, which was calculated using age, hepatic enzymes, and platelet count, on 2-year heart failure readmissions was investigated. Results: A total of 272 patients (median age 85 (82, 88) years old, 76 (28%) men) were included. The median baseline fibrosis-4 index was 2.8 (2.2, 3.7). A high fibrosis-4 index (>3.79) was associated with higher cumulative incidence of the primary endpoint (18% versus 4%, p < 0.001) and higher event rates (0.1041 versus 0.0222 events/year, p < 0.001), with an adjusted hazard ratio of 1.27 (95% confidence interval 1.04–1.54, p = 0.019). Conclusion: an elevated fibrosis-4 index at baseline, indicating the existence of persistent hepatic congestion, was associated with incidences of heart failure following TAVR. Calculating the fibrosis-4 index before TAVR is highly encouraged for risk stratification and shared decision making.

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Section: Fibrosis-4 Index and Aortic Stenosissupporting

confidence: 85%

Section: Fibrosis-4 Index and Aortic Stenosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Implications of Elevated Fibrosis-4 Index in Patients Receiving Trans-Catheter Aortic Valve Replacement

Imamura

Narang

Onoda

et al. 2021

JCM

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“…9 Another study including 1162 patients with acute heart failure demonstrated that high FIB-4 at admission was a significant predictor of the composite of all-cause death and rehospitalization due to heart failure. 22 However, a post-hoc analysis of the TOPCAT trial, which included only heart failure patients with preserved LVEF, reported that FIB-4 was not a significant risk factor for cardiac events. 23 Although several studies have evaluated the prognostic significance of FIB-4, there have been no reports evaluating the association between FIB-5 and prognosis in patients with heart failure.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of the liver fibrosis marker fibrosis‐5 index in patients with acute heart failure

et al. 2022

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Aims Recently, liver fibrosis markers, such as the fibrosis-4 index (FIB-4), have been shown to be associated with prognosis in patients with heart failure. The fibrosis-5 (FIB-5) index, which assesses albumin, alkaline phosphatase, aspartate transaminase, alanine aminotransferase and platelet count, is a simple liver fibrosis marker that was reported to be superior to FIB-4 for differentiation of liver fibrosis. This study aimed to compare the prognostic value of FIB-4 and FIB-5 in patients with heart failure. Methods and resultsThe FIB-4 and FIB-5 scores were calculated at discharge in 906 patients hospitalized with heart failure. The patients were stratified into three groups based on their FIB-5 scores: low (n = 303), middle (n = 301), and high (n = 302) FIB-5 groups. The primary endpoint was a composite of cardiac death or rehospitalization for heart failure. The low FIB-5 group was older and had larger inferior vena cava diameters and higher brain natriuretic peptide levels than the other two groups. The primary endpoint occurred in 156 (51.5%), 110 (36.5%), and 54 patients (17.9%) in the low, middle, and high FIB-5 groups, respectively (P < 0.001). On Cox proportional hazard analysis, the low FIB-5 was independently associated with the primary endpoint after adjustment for confounding factors. The association was consistent in both patients with preserved and reduced left ventricular ejection fraction (LVEF), and there was no significant interaction between LVEF phenotypes in terms of the prognostic impact of FIB-5 (P for interaction = 0.311). FIB-5 was superior to FIB-4 as a prognostic indicator of the primary endpoint (continuous net reclassification improvement, 0.530; 95% confidence interval [CI], 0.399-0.662; P < 0.001; integrated discrimination improvement, 0.072; 95% CI, 0.057-0.088; P < 0.001). Conclusions The FIB-5 is a useful risk stratification marker with better prognostic value than FIB-4 in patients hospitalized with heart failure.

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“…This index has been used across many hepatic diseases (12)(13)(14), and several studies have described the association between a high FIB4 index and poorer outcomes (15,16), not only for hepatic disease but also for non-hepatic disease. Previous studies reported that the FIB4 index was associated with long-term mortality and readmission rate of heart failure patients (17,18). Some reports have shown that the FIB-4 index is not only a predictor of background liver fibrosis but also a prognostic factor after hepatectomy in patients with colorectal cancer liver metastases (19).…”

Section: Introductionmentioning

confidence: 98%

Preoperative Fibrosis-4 (FIB-4) Evaluation May Be Helpful to Evaluate Prognosis of Gastric Cancer Patients Undergoing Operation: A Retrospective Study

Shi

Zhang

et al. 2021

Front. Oncol.

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BackgroundLiver dysfunction and chronic inflammation influence the prognosis of many tumors and surgical outcomes. This study was performed to determine whether the Fibrosis-4 (FIB-4) index, originally defined as a noninvasive fibrosis marker, can predict the prognosis of patients with gastric cancer undergoing radical gastric cancer surgery.MethodsWe have retrospectively analyzed 594 consecutive patients with gastric cancer who underwent gastrectomy in our database. The FIB-4 index was calculated using laboratory data and age before gastrectomy. The clinical utility of FIB-4 was evaluated by X-tile. Patients were divided into two groups (high and low FIB-4 index groups), and their overall survival (OS) was investigated. Cox regression analysis was used to identify the independent parameters associated with prognosis. Finally, we developed a prognostic prediction model by using R statistical software.ResultsA total of 556 patients, including 422 men and 134 women, were enrolled. Of these, 61 (11.0%) and 495 (89.0%) patients had low and FIB-4 indexes, respectively. In addition to the indicators of FIB-4, preoperative age, tumor site, surgical procedure, TNM stage, and postoperative complications were found to be independent predictors of prognosis (P < 0.05). Among patients, the FIB-4 index group had significantly shorter OS (log-rank P = 0.01) than the low FIB-4 index group. This association was also confirmed in the multivariate analysis (hazard ratio, 4.65; 95% confidence interval, 1.07-4.29; P = 0.031).ConclusionsPreoperative FIB-4 index can predict long-term outcomes of gastric cancer patients who had undergone gastrectomy.

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Impact of predictive value of Fibrosis-4 index in patients hospitalized for acute heart failure

Cited by 27 publications

References 42 publications

Implications of Elevated Fibrosis-4 Index in Patients Receiving Trans-Catheter Aortic Valve Replacement

Implications of Elevated Fibrosis-4 Index in Patients Receiving Trans-Catheter Aortic Valve Replacement

Prognostic value of the liver fibrosis marker fibrosis‐5 index in patients with acute heart failure

Preoperative Fibrosis-4 (FIB-4) Evaluation May Be Helpful to Evaluate Prognosis of Gastric Cancer Patients Undergoing Operation: A Retrospective Study

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