Key result
Higher FIB-5 index is linked to ~8% lower long-term mortality in HFrEF.
Why the study?
Fibrosis-4 and fibrosis-5 indices may reflect systemic pathophysiological changes related to adverse cardiovascular prognosis, but their predictive value for long-term mortality in heart failure patients was unclear.
Do baseline Fibrosis-4 (FIB-4) and Fibrosis-5 (FIB-5) index values predict long-term all-cause mortality in patients with heart failure with reduced ejection fraction (HFrEF)?
Cohort (n=593)
Yes
Do baseline Fibrosis-4 (FIB-4) and Fibrosis-5 (FIB-5) index values predict long-term all-cause mortality in patients with heart failure with reduced ejection fraction (HFrEF)?
Odds Ratio: 0.92 (95% CI 0.88–0.96)
Absolute Event Rate: 59.9% vs 40.5%
p-value: p=<0.001
Both FIB-4 and FIB-5 are associated with long-term mortality in HFrEF, but FIB-5 serves as a more reliable and independent prognostic biomarker, particularly in patients aged ≤75 years and independent of right ventricular dysfunction.
Lower FIB-5 may flag higher long-term mortality risk in HFrEF; leaves open incremental value beyond standard markers in prospective cohorts.
Introduction: Fibrosis-4 (FIB-4) and fibrosis-5 (FIB-5) indices are non-invasive biomarkers originally developed for hepatic fibrosis but may reflect systemic pathophysiological changes related to adverse cardiovascular prognosis. We aimed to investigate whether baseline FIB-4 and FIB-5 values predict long-term mortality in patients with heart failure (HF). Methods: This retrospective observational study included 593 patients with HF who had available long-term mortality data. FIB-4 and FIB-5 indices were calculated at admission. Patients were followed for all-cause mortality, and outcomes were evaluated at 1-year, 3-year, and 5-year intervals. Clinical, laboratory, and echocardiographic parameters were compared between survivors and non-survivors. Results: During follow-up, 1-year, 3-year, and 5-year mortality rates were 24.6%, 39.0%, and 49.7%, respectively. Non-survivors had significantly higher FIB-4 and FIB-5 values compared with survivors (P<0.001 for both). ROC curve analyses demonstrated that both indices had significant predictive performance for long-term mortality. Optimal cut-off values showed good sensitivity and specificity for identifying high-risk patients. Conclusion: Higher FIB-4 and FIB-5 values are associated with greater long-term mortality risk in HF patients. These indices may serve as practical, cost-effective prognostic biomarkers for mortality risk stratification in routine clinical care.
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Yalvaç et al. (2026) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) (n=593). Low Fibrosis-5 (FIB-5) index vs. High Fibrosis-5 (FIB-5) index was evaluated on 5-year all-cause mortality (OR 0.92, 95% CI 0.88-0.96, p=<0.001). Lower Fibrosis-5 (FIB-5) index values were independently associated with an increased risk of long-term all-cause mortality in patients with heart failure with reduced ejection fraction (OR 0.92).
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