Fibrosis‐4 index reflects right ventricular function and prognosis in heart failure with preserved ejection fraction

Nakashima, Mitsuyoshi; Sakuragi, Satoru; Miyoshi, Toru; Takayama, Shin; Kawaguchi, Tatsuto; Kodera, Nobuhisa; Akai, Hiroaki; Koide, Yuji; Otsuka, Hiroaki; Kono, Kenji; Tanakaya, Machiko; Katayama, Yusuke; Ito, Hiroshi

doi:10.1002/ehf2.13317

Cited by 36 publications

(51 citation statements)

References 26 publications

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“…8 FIB-4 has also been shown to be a good prognostic marker of death or rehospitalization due to heart failure in patients with heart failure. [9][10][11] On the other hand, the fibrosis-5 (FIB-5) index, which is calculated using albumin, alkaline phosphatase (ALP), AST to ALT ratio, and PLT count, was recently proposed as a simple liver fibrosis marker. 12 The predictive value of FIB-5 for liver fibrosis was first validated in patients with HCV infection.…”

Section: Introductionmentioning

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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Section: Introductionmentioning

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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“…The fibrosis-4 (FIB-4) index is a simple and useful test that can assess liver fibrosis in patients with liver diseases and is recommended as a clinically useful tool for screening or determining the risk of non-alcoholic fatty liver disease. [14][15][16][17] Recently, the FIB-4 index has been used to determine the prognosis for patients with HF. [18][19][20] At Iwakuni Clinical Center, it was determined that the FIB-4 index score reflects right ventricular dysfunction and a poor prognosis for patients with HF and preserved ejection fraction.…”

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confidence: 99%

“…[18][19][20] At Iwakuni Clinical Center, it was determined that the FIB-4 index score reflects right ventricular dysfunction and a poor prognosis for patients with HF and preserved ejection fraction. 17 However, the association between the FIB-4 index score and the prognosis for patients with severe isolated TR remains unclear.…”

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confidence: 99%

The Fibrosis-4 Index Predicts Cardiovascular Prognosis in Patients With Severe Isolated Tricuspid Regurgitation

Nakashima

Tanakaya

Miyoshi

et al. 2022

Circ J

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Background:The fibrosis-4 (FIB-4) index is used to evaluate liver disease patients. It can also be used to evaluate the prognosis for heart disease patients; however, its ability to determine the prognosis of severe isolated tricuspid regurgitation (TR) patients is unclear. This study aimed to clarify the association between FIB-4 index scores and the cardiovascular prognosis for severe isolated TR patients. Methods and Results:This was a dual-center, retrospective study. From 2011 to 2019, 111 consecutive outpatients with severe isolated TR (mean age, 68.6 years; 53.2% male) were evaluated. Major adverse cardiovascular events (MACEs) were defined as the composite of cardiovascular death, hospitalization for heart failure, myocardial infarction, and stroke. The association between FIB-4 index scores and echocardiography was also evaluated. During a median follow up of 3.0 years, 24 patients were lost to follow up and 40 MACEs occurred. Baseline FIB-4 index scores for patients with MACEs were significantly higher than those for patients without MACEs. A multivariate analysis revealed that FIB-4 index scores are significantly associated with MACEs (hazard ratio, 1.89; 95% confidence interval, 1.01-3.54; P=0.046). A linear regression analysis indicated that FIB-4 index scores were correlated with echocardiographic parameters, including the left atrial volume index and left ventricular end-diastolic diameter. Conclusions:The FIB-4 index score may be a useful predictor of MACEs for patients with severe isolated TR.

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“…The Fib-4 index and ALBI score used in the present study are not only scoring systems for hepatic function 15 , 17 , but they have also recently been reported as prognostic factors for cancer immunotherapy for hepatocellular carcinoma 20 – 22 , cardiac disease 23 , 24 and coronavirus disease 25 , 26 . Additionally, they are presumed to be scores that reflect general conditions related to cachexia.…”

Section: Discussionmentioning

confidence: 91%

FAN score comprising fibrosis-4 index, albumin–bilirubin score and neutrophil–lymphocyte ratio is a prognostic marker of urothelial carcinoma patients treated with pembrolizumab

Kawashima

Yamamoto

Sato

et al. 2021

Sci Rep

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It is important to identify prognostic and predictive markers of metastatic urothelial carcinoma (mUC) treated with immunocheckpoint inhibitors. We sought to establish a prognostic marker for patients with mUC treated with pembrolizumab based on only blood test results. We included 165 patients with mUC in the discovery cohort and 103 with mUC who were treated with pembrolizumab in the validation cohort. Multivariate and Cox regression analyses were used to analyse the data. In the discovery cohort, the fibrosis-4 index (hazard ratio [HR]: 2.13, 95% confidence interval [CI] 1.20–3.76, p = 0.010), albumin–bilirubin score (HR 1.91, 95% CI 1.27–2.88, p = 0.002), and neutrophil–lymphocyte ratio (HR: 1.84, 95% CI 1.22–2.79, p = 0.004) were independent significant prognostic factors. We established a ‘FAN score’ that included these three aforementioned items, which were assigned one point each. We divided patients into the 0–1 point (n = 116) and 2–3 points (n = 49) groups. The FAN score was a significant prognostic marker for cancer-specific survival (CSS) (HR 1.48, 95% CI 1.19–1.83, p < 0.001) along with the Eastern Cooperative Oncology Group Performance Status. The FAN score was also a prognostic factor of progression-free survival (PFS) (HR: 1.25, 95% CI 1.01–1.54, p = 0.036) along with the presence of liver metastasis. In the validation cohort, the FAN score was a significant prognostic factor for CSS (HR: 1.48, 95% CI 1.19–1.85, p = 0.001) and PFS (HR: 1.29, 95% CI 1.02–1.62, p = 0.034). We established the FAN score as a prognostic marker for patients with mUC treated with pembrolizumab.

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Fibrosis‐4 index reflects right ventricular function and prognosis in heart failure with preserved ejection fraction

Cited by 36 publications

References 26 publications

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

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

The Fibrosis-4 Index Predicts Cardiovascular Prognosis in Patients With Severe Isolated Tricuspid Regurgitation

FAN score comprising fibrosis-4 index, albumin–bilirubin score and neutrophil–lymphocyte ratio is a prognostic marker of urothelial carcinoma patients treated with pembrolizumab

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