Does a high FIB4 index predict all-cause mortality and HF events in patients with acute heart failure requiring intensive care?
A high FIB4 index in the acute phase of acute heart failure independently predicts 1-year all-cause mortality and heart failure events, likely reflecting congestive liver and hypoperfusion.
/μL] × √alanine aminotransferase U/L). However, the clinical impact of the FIB4 index in the acute phase of acute heart failure (AHF) has not been sufficiently investigated.A total 1,468 AHF patients were analyzed. The median FIB4 index was 2.71 1.85-4.22. The patients were divided into three groups according to the quartiles of their FIB4 index (low-FIB4 Q1, ≤ 1.847, middle-FIB4 Q2/Q3, 1.848-4.216, and high-FIB4 Q4, ≥ 4.216 groups). A Kaplan-Meier curve analysis showed that the prognosis, such as all-cause mortality and HF events within 365 days, was significantly poorer in the high-FIB4 group than in the middle-FIB4 and low-FIB4 groups. A multivariate Cox regression model identified high FIB4 index as an independent predictor of 365-day all-cause death (hazard ratio (HR): 1.660, 95% CI: 1.136-2.427) and HF events (HR: 1.505, 95% CI: 1.145-1.978). The multivariate logistic regression analysis showed that the high plasma volume status (PVS) (Q4, odds ratio OR: 2.099, 95% CI: 1.429-3.082), low systolic blood pressure (SBP) (< 100 mmHg, OR: 3.825, 95% CI: 2.504-5.840), and low left ventricular ejection fraction (< 40%, OR: 1.321, 95% CI: 1.002-1.741) were associated with a high FIB4 index.A high FIB4 index can predict adverse outcomes in AHF patients, which indicate that congestive liver and liver hypoperfusion occur due to low cardiac output in the acute phase of AHF.
Shirakabe et al. (Fri,) studied this question.