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Published on: January 8, 2013

The predictive role of the FIB-4 index in identifying arrhythmic risk among patients with nonischemic dilated

Firdevs Aysenur Ekizler1, Bahar Tekin Tak1, Serkan Cay1

  • 1Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.

International Journal of Cardiology
|July 1, 2026
PubMed

Insights

The Fibrosis-4 (FIB-4) index can predict major arrhythmic events in patients with nonischemic dilated cardiomyopathy (NIDCM). This accessible marker helps identify high-risk individuals for closer monitoring and interventions.

Area of Science:

  • Cardiology
  • Biomarkers
  • Arrhythmology

Background:

  • Nonischemic dilated cardiomyopathy (NIDCM) poses challenges in identifying patients at risk for ventricular arrhythmias.
  • The Fibrosis-4 (FIB-4) index, a liver fibrosis marker, shows potential in cardiovascular risk assessment.
  • Current methods for risk stratification in NIDCM require further noninvasive tools.

Purpose of the Study:

  • To investigate the association between FIB-4 index levels and the risk of major arrhythmic events in NIDCM patients.
  • To determine if FIB-4 can serve as an independent predictor of adverse arrhythmic outcomes in this population.

Main Methods:

  • A cohort of 1233 NIDCM patients was evaluated.
  • The primary endpoint was a composite of sudden cardiac death, sustained ventricular tachycardia/fibrillation, or appropriate ICD therapy.
  • Follow-up was conducted for a median of 70 months.

Main Results:

  • The composite arrhythmic event occurred in 29.8% of patients during follow-up.
  • A FIB-4 cut-off of 1.67 demonstrated 66% sensitivity and 81% specificity for predicting the primary endpoint.
  • FIB-4 ≥ 1.67 was independently associated with increased arrhythmic risk (HR: 4.88, p < 0.001) after multivariate analysis.

Conclusions:

  • The FIB-4 index is an independent predictor of major arrhythmic events and mortality in NIDCM patients.
  • The readily available FIB-4 index can aid in identifying high-risk NIDCM patients.
  • FIB-4 may guide closer monitoring or prophylactic interventions for at-risk individuals.
Abstract

Keywords:
Arrhythmic eventsCardiovascular deathDilated cardiomyopathyFibrosis indexICD therapyRisk stratification

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