Abstract
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.