Impact of predictive value of Fibrosis-4 index in patients hospitalized for acute heart failure
Impact of predictive value of Fibrosis-4 index in patients hospitalized for acute heart failure
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DOI：
10.1016/j.ijcard.2020.09.056
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发表时间：
2021-01-12
影响因子：
3.5
通讯作者：
Murohara, Toyoaki
中科院分区：
文献类型：
--
作者：
Shibata, Naoki;Kondo, Toru;Murohara, Toyoaki
背景：急性心力衰竭(AHF)患者常出现肝功能异常。纤维化-4(Fibrosis-4，FIB4)指数是一种无创且易于计算的指标，已被用于肝脏疾病，并反映了不良预后。目前尚不清楚入院时的FIB4指数是否能预测AHF患者的不良结局。方法和结果：从多中心AHF登记资料中，我们回顾评估了1162名因AHF入院的患者(中位年龄78[69-85]岁，702名患者[60.4%]为男性)。入院时FIB4指数计算为：年龄(岁)×天冬氨酸氨基转移酶[U/L]/(血小板计数[10(3)/亩L]×根丙氨酸氨基转移酶[U/L]。入院时FIB4指数的中位数为2.79。全因死亡率和12个月时因心力衰竭而再住院的患者被调查为一个复合终点，分别发生在142名(12.2%)患者和232名(20%)患者。卡普兰-迈耶分析显示，综合终点从FIB4指标值的第一个四分位数组显著增加到第四个四分位数组(对数排名，p<；0.001)。多变量COX回归模型显示，FIB4指数是急性心力衰竭患者复合终点的独立危险预测因子(3个月：HR比1.013[95%可信区间：1.001-1.025]；p=0.03，12个月：HR 1.015[95%CI：1.005-1.025]；p=0.003)。然而，天冬氨酸氨基转移酶、丙氨酸氨基转移酶和血小板计数都不是一个有意义的预测因素。结论：入院时用FIB4指数评估肝功能障碍是AHF患者全因死亡率和再住院的综合终点的预测因素。(C)2020爱思唯尔B.V.保留所有权利。Y
Background: Abnormalities in liver function tests commonly occur in patients with acute heart failure (AHF). The Fibrosis-4 (FIB4) index, a non-invasive and easily calculated marker, has been used for hepatic diseases and reflects adverse prognosis. It is not clearly established whether the FIB4 index at admission can predict adverse outcomes in patients with AHF.Methods and results: From a multicenter AHF registry, we retrospectively evaluated 1162 consecutive patients admitted due to AHF (median age 78 [69-85] years and 702 patients [60.4%] were male). The FIB4 index at admission was calculated as: age (yrs) x aspartate aminotransferase [U/L]/(platelets count [10(3)/mu L] x root alanine aminotransferase [U/L]. The median value of the FIB4 index at admission was 2.79. All-cause mortality and rehospitalization due to HF at 12 months were investigated as a composite endpoint and occurred in 142 (12.2%) patients and 232 (20%) patients, respectively. Kaplan-Meyer analysis shows a significant increase in the composite endpoint from the first to fourth quartile group of the FIB4 index values (log-rank, p < 0.001). Multivariate Cox regression model revealed the FIB4 index was an independent risk predictor for composite endpoint in patients with AHF (3 months: HR ratio 1.013 [95% Confidence interval (CI):1.001-1.025]; p = 0.03, 12 months: HR 1.015 [95% CI:1.005-1.025]; p = 0.003, respectively). However, neither aspartate aminotransferase, alanine aminotransferase, nor platelet count was found to be a significant predictor.Conclusions: Hepatic dysfunction evaluated with the FIB4 index at admission is a predictor of the composite endpoint of all-cause mortality and rehospitalization in AHF patients. (C) 2020 Elsevier B.V. All rights reserved.Y