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March 17, 2025International Journal of CardiologyOpen Access

The prognostic role of Fibrosis-4 score in heart failure with reduced ejection fraction

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Why the study?

HFrEF and MASLD are both associated with liver fibrosis, but the association of FIB-4 score with mortality and liver outcomes in HFrEF required examination.

Does a high FIB-4 score predict increased mortality and major adverse liver outcomes in patients with HFrEF?

Population

4523 HFrEF patients from the Danish Heart Failure Registry

Comparison

High-risk vs indeterminate-risk vs low-risk FIB-4 score groups

Design

Registry-based cohort study

Follow-up

Five years

Key result

A high FIB-4 score in patients with HFrEF was associated with a higher 5-year incidence of all-cause mortality compared to a low score (43% vs 23%; HR 1.51, 95% CI 1.31-1.74).

Authors

AMAbdullahi Ahmed MohamedDCDaniel Mølager ChristensenMMMilan Mohammad

Discussion

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Member takes

Overview

High FIB-4 may stratify mortality risk in HFrEF; hypothesis-generating and requires prospective validation before clinical use.

Study Design

Type

Cohort (n=4,523)

Multicenter

Yes

Structured PICO

Does a high FIB-4 score predict increased mortality and major adverse liver outcomes in patients with HFrEF?

P
Population
4,523 patients with heart failure with reduced ejection fraction from the Danish Heart Failure Registry, followed for 5 years.
E
Exposure
High or indeterminate Fibrosis-4 (FIB-4) score
C
Comparator
Low Fibrosis-4 (FIB-4) score
O
Outcome
All-cause mortality, cardiovascular mortality, and major adverse liver outcomes (MALO)hard clinical

Main Result

Hazard Ratio: 1.51 (95% CI 1.31–1.74)

Absolute Event Rate: 43% vs 23%

A high FIB-4 score in patients with HFrEF is a significant prognostic marker associated with increased all-cause mortality, cardiovascular mortality, and major adverse liver outcomes.

Cite This Study

Mohamed et al. (2025) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) (n=4,523). High FIB-4 score vs. Low FIB-4 score was evaluated on all-cause mortality (HR 1.51, 95% CI 1.31-1.74). A high FIB-4 score in patients with HFrEF was associated with a higher 5-year incidence of all-cause mortality compared to a low score (43% vs 23%; HR 1.51, 95% CI 1.31-1.74).

synapsesocial.com/papers/6a882ed933299ecf904fce11https://doi.org/10.1016/j.ijcard.2025.133174
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