Prognostic impacts of fibrosis-5 index in patients with chronic heart failure

We aimed to evaluate the usefulness of the Fibrosis-5 index (FIB-5) for predicting prognosis in patients with chronic heart failure and examine whether combining the Fibrosis-4 (FIB-4) and FIB-5 indices could enhance risk stratification in heart failure. This single-center retrospective cohort study analyzed data from an inpatient database. A total of 1,100 patients (mean age, 78 years; 58.2% male) were included. The primary endpoint was a composite event (all-cause mortality and rehospitalization for heart failure) within 1 year of hospital discharge, assessed before and after propensity score matching (PSM). Receiver operating characteristic curve analysis identified - 0.85 as the optimal FIB-5 cutoff value for predicting composite events, classifying patients into high- and low-FIB-5 groups. The low-FIB-5 group had significantly higher event rates than the high-FIB-5 group, both before and after PSM. A cubic spline curve analysis showed that lower FIB-5 values were associated with significantly higher composite event rates. In multivariable Cox regression analysis, low FIB-5 (< - 0.85) was significantly associated with the 1-year composite endpoint compared with the high-FIB-5 index. Among patients in the moderate-risk FIB-4 category, those with high FIB-5 values exhibited outcomes comparable to the low-risk FIB-4 group, whereas those with low FIB-5 values showed risks similar to the high-risk FIB-4 group. The FIB-5 index may serve as a useful prognostic marker in patients with chronic heart failure. Combining the FIB-4 and FIB-5 indices enables refined risk stratification by identifying high-risk individuals within the moderate-risk FIB-4 category using only routinely available laboratory parameters.