Fibrosis 4 Index Predicts Haemocompatibility-Related Adverse Events in Patients Using Left Ventricular Assist Devices

This study aimed to explore the association between the liver fibrosis-4 (FIB4) index and clinical events, specifically haemocompatibility-related adverse events (HRAEs), in patients who underwent left ventricular assist device (LVAD) implantation.

The study involved patients who received LVADs for advanced heart failure (HF) treatment. FIB4 index was calculated both preoperatively and postoperatively, and its association with clinical events was examined, focusing on all-cause mortality and HRAEs, which included severe bleeding, cerebrovascular accidents, and intra-pump thrombosis.

A total of 224 patients with LVAD were analyzed. The value of FIB4 index was significantly decreased after LVAD implantation, and the postoperative FIB4 index was independently associated with composite events, including all-cause death and HRAEs after adjustment of cofounders. Next, we clarified the association between postoperative FIB4 index and clinical events after LVAD implantation. Patients were divided into 2 groups based on a postoperative FIB4 index threshold of 1.45. The high FIB4 group was associated an elevated risk of HRAEs (P = 0.0038), with no significant difference in survival curves between the groups. Additionally, the high FIB4 group showed elevated von Willebrand factor activity, while no significant differences were found in prothrombin time international normalized ratio variability.

FIB4 index, a liver fibrosis marker, serves as a valuable prognostic indicator for HRAEs in patients receiving LVAD support.