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

Abstract

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.

Prognostic value of the liver fibrosis marker fibrosis-5 index in patients with severe isolated tricuspid regurgitation: comparison with fibrosis-4 index

“…In young patients, the value of the FIB4 will tend to be relatively low score even if their liver dysfunction is high grade. Whether their result could apply to younger patient population is still unknown because the study populations in previous studies which evaluated the prognostic value of the FIB4 in patients with cardiovascular diseases mainly included elderly patients [13][14][15][16][17]20]. At this point, the FIB5 might be efficient to apply versatilely because its calculation formula does not include age.…”

Liver Fibrosis Scores and Coronary Artery Disease: Novel Findings in Patients with Metabolic Dysfunction-Associated Fatty Liver Disease

“…Previous cross-sectional studies and meta-analyses have reported that CAC scores reflect CAD severity and are associated with adverse cardiovascular outcomes. [38][39][40] Park et al also reported a significant association between liver fibrosis and coronary artery calcification development. 15 Therefore, we conducted further analysis and found that FIB-4 score and NFS were directly correlated with CAC scores, consistent with a previous study.…”

Prognostic value of fibrosis-5 index combined with C-reactive protein in patients with acute decompensated heart failure

“…Recently, the fibrosis-5 (FIB-5) [ 14 ] index using albumin, alkaline phosphatase (ALP), aspartate aminotransferase(AST)/alanine aminotransferase (ALT) ratio, and PLT count has been shown to be superior to the FIB-4 index in predicting severe cirrhosis in patients with chronic hepatitis B and C [ 15 , 16 ]. The FIB-5 index has better long-term prognostic value than the FIB-4 index as a valuable risk stratifier for the outcomes of cardiac death or rehospitalization in patients with AHF [ 17 ].…”