The predictive role of the FIB-4 index in identifying arrhythmic risk among patients with nonischemic dilated cardiomyopathy
International Journal of Cardiology, cilt.461, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 461
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.ijcard.2026.134657
- Dergi Adı: International Journal of Cardiology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE, Public Affairs Index, Academic Search Ultimate (EBSCO)
- Anahtar Kelimeler: Arrhythmic events, Cardiovascular death, Dilated cardiomyopathy, Fibrosis index, ICD therapy, Risk stratification
- Dokuz Eylül Üniversitesi Adresli: Evet
Özet
Background: Identifying patients with nonischemic dilated cardiomyopathy (NIDCM) who are at increased risk for life-threatening ventricular arrhythmias remains a clinical challenge. The Fibrosis-4 (FIB-4) index, a noninvasive marker originally developed to evaluate liver fibrosis, has been shown to be associated with increased risk of adverse events in several cardiovascular diseases. This study aimed to investigate the relationship between FIB-4 levels and arrhythmic risk in patients diagnosed with NIDCM. Methods: A total of 1233 consecutive patients with NIDCM (714 men; 59.6 ± 12.4 years) were evaluated. The primary endpoint was the composite major arrhythmic event, including sudden cardiac death (SCD), documented sustained ventricular tachycardia or fibrillation, or appropriate implantable cardioverter defibrillator (ICD) therapy. Cardiovascular death and all-cause death were also evaluated as the secondary endpoints. Results: During a median follow-up period of 70 months (interquartile range: 60 to 85 months), the primary endpoint was developed in 367(29.8%) patients. ROC analysis showed that using a cut-off level of 1.67, FIB-4 predicted the occurrence of the composite primary endpoint with a sensitivity of 66% and specificity of 81%. On multivariate analysis, after adjusting for other confounding factors, FIB-4 ≥ 1.67 remained independently associated with arrhythmic risk (HR: 4.88, 95% CI: 3.92–6.07, p < 0.001). Conclusions: This study showed that the FIB-4 index is an independent predictor of major arrhythmic events and death in patients with NIDCM. As a readily available index, FIB-4 may offer additional value in identifying high-risk patients who may benefit from closer monitoring or prophylactic interventions in this patient population.