Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan.
Department of Cardiovascular Medicine, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan.
Heart Vessels. 2023 Sep;38(9):1181-1189. doi: 10.1007/s00380-023-02268-3. Epub 2023 Apr 23.
The fibrosis-4 index (FIB4), a liver fibrosis maker, has been shown to be associated with the prognosis in patients with severe isolated tricuspid regurgitation (TR). Recent study showed that the fibrosis-5 index (FIB5), which was calculated by albumin, alkaline phosphatase, aspartate transaminase, alanine aminotransferase and platelet count, had better prognostic value than FIB4 in patients with heart failure. The aim of this study was to evaluate the usefulness of FIB5 index for predicting prognosis in patients with severe isolated TR and compare the prognostic value between the FIB4 and the FIB5 in those patients. This was a dual-center, retrospective study. 113 consecutive outpatients with severe isolated TR (mean age, 65.8 years; 47.8% male) were analyzed. Major adverse cardiovascular events (MACEs) were defined as the composite of cardiovascular death, hospitalization for heart failure, myocardial infarction, and stroke. During a median follow-up of 3.0 years, 41 MACEs occurred. Patients with MACEs had a lower the FIB5 than patients without MACEs. The multivariate Cox analysis revealed that the FIB5 < -4.30 was significantly associated with higher incidence of MACEs after adjusted by confounding factors. Receiver-operating characteristic curve analyses showed that prognostic values did not differ between the FIB5 and the FIB4 in whole patients and in patients aged ≥ 70 years; while, in patients aged < 70 years, the FIB5 had better prognostic value than the FIB4. The FIB5 may be a useful predictor of MACEs in patients with severe isolated TR.
纤维-4 指数（FIB4）是一种肝纤维化标志物，已被证明与严重孤立性三尖瓣反流（TR）患者的预后相关。最近的研究表明，由白蛋白、碱性磷酸酶、天冬氨酸转氨酶、丙氨酸转氨酶和血小板计数计算得出的纤维-5 指数（FIB5）在心衰患者中比 FIB4 具有更好的预后价值。本研究旨在评估 FIB5 指数在预测严重孤立性 TR 患者预后中的作用，并比较 FIB4 和 FIB5 在这些患者中的预后价值。这是一项双中心、回顾性研究。分析了 113 例连续的严重孤立性 TR 门诊患者（平均年龄 65.8 岁；47.8%为男性）。主要不良心血管事件（MACE）定义为心血管死亡、心力衰竭住院、心肌梗死和中风的复合事件。在中位数为 3.0 年的随访期间，发生了 41 例 MACE。发生 MACE 的患者的 FIB5 低于未发生 MACE 的患者。多变量 Cox 分析表明，在调整混杂因素后，FIB5 <-4.30 与 MACE 发生率升高显著相关。受试者工作特征曲线分析显示，在所有患者和年龄≥70 岁的患者中，FIB5 和 FIB4 的预后价值无差异；而在年龄<70 岁的患者中，FIB5 的预后价值优于 FIB4。FIB5 可能是严重孤立性 TR 患者 MACE 的有用预测指标。
