Abstract 12989: Long-term Prognostic Value of Fibrosis-4 Index and Albumin-bilirubin Score in Patients Admitted for Acute Decompensated Heart Failure

Abstract

Backgrounds: Cardiohepatic interactions have been a focus of attention among heart failure (HF). It was reported that liver stiffness assessed by non-invasive fibrosis marker such as Fibrosis-4(FIB4) index provide prognostic information in HF patients. Furthermore, the albumin-bilirubin (ALBI) score has recently been proposed as a validated index of liver dysfunction. We sought to investigate the long-term prognostic values of the combination of FIB4 index and ALBI score in patients admitted for acute decompensated heart failure (ADHF). Methods and Results: We studied 299 ADHF pts with survival discharge. FIB4 index was calculated by the formula: age(yrs) х AST[U/L]/(platelets [10 3 /μL] х (ALT[U/L]) 1/2 ). The ALBI was calculated using the formula: log 10 (total bilirubin) х 0.66 + albuminх-0.085. During a follow-up period of 4.3±3.3 yrs, 94 patients died. At multivariate Cox analysis, FIB4 index and ALBI score were significantly associated with total mortality, independently of prior HF hospitalization and body mass index after adjustment with systolic blood pressure, left ventricular end-diastolic dimension and left atrial dimension indexes. Patients with both greater FIB4 index (>3.608: top tertile) and ALBI score (>-2.076:top tertile) had a significantly higher risk of total mortality than those with either or none of them (46% vs 34% vs 25%, respectively, p=0.002). Conclusion: The combination of FIB4 index and ALBI score might identify higher risk subset for total mortality in ADHF patients.