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首页> 外文期刊>Journal of Clinical Medicine >Impact of the Fibrosis-4 Index on Risk Stratification of Cardiovascular Events and Mortality in Patients with Atrial Fibrillation: Findings from a Japanese Multicenter Registry
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Impact of the Fibrosis-4 Index on Risk Stratification of Cardiovascular Events and Mortality in Patients with Atrial Fibrillation: Findings from a Japanese Multicenter Registry

机译：纤维化-4纤维化-4指标对心房颤动患者心血管事件和死亡率风险分层的影响：日本多中心注册表的研究结果

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Background: Liver diseases drive the development and progression of atrial fibrillation (AF). The Fibrosis-4 (FIB4) index is a non-invasive scoring method for detecting liver fibrosis, but the prognostic impact of using it for AF patients is still unknown. Herein, we evaluated using the FIB4 index as a risk assessment tool for cardiovascular events and mortality in patients with AF. Methods: We performed a post-hoc analysis of a prospective, observational multicenter study. A total of 3067 patients enrolled in a multicenter Japanese registry were grouped as first tertile (FIB4 index 1.75, n = 1022), second tertile (1.75 ≤ FIB4 index 2.51, n = 1022), and third tertile (FIB4 index ≥ 2.51, n = 1023). Results: The third tertile had statistically significant results: older age, lower body mass index, increased heart failure prevalence, and lower clearances of hemoglobin and creatinine (all p 0.05). During the follow-up period, incidences of major bleeding, cardiovascular events, and all-cause mortality were significantly higher for the third tertile (all p 0.05). After multivariate adjustment, the third tertile associated independently with cardiovascular events (HR 1.72; 95% CI 1.31–2.25) and all-cause mortality (HR 1.43; 95% CI 1.06–1.95). Adding the FIB4 index to a baseline model with CHA 2 DS 2 -VASc score improved the prediction of cardiovascular events and all-cause mortality, as shown by the significant increase in the C-statistic (all p 0.05), net reclassification improvement (all p 0.001), and integrated discrimination improvement (all p 0.001). A FIB4 index ≥ 2.51 most strongly associated with cardiovascular events and all-cause mortality in AF patients with high CHADS 2 scores (all p 0.001). Conclusions: The FIB4 index is independently associated with risks of cardiovascular events and all-cause mortality in AF patients.
机译：背景：肝脏疾病推动心房颤动的发展和进展（AF）。纤维化-4（FIB4）指数是一种用于检测肝纤维化的非侵入性评分方法，但使用它对于AF患者的预后影响仍然未知。在此，我们使用FIB4指数评估为AF的患者心血管事件和死亡率的风险评估工具。方法：我们对前瞻性，观测的多中心研究进行了HOC分析。共有3067名患者在多中心日本登记处进行注册，分为第一型泰利尔（FIB4指数<1.75，N = 1022），第二张力（1.75≤FIB4索引<2.51，N = 1022）和第三张力（FIB4指数≥2.51 ，n = 1023）。结果：第三届TERTILE具有统计学显着的结果：年龄较大的年龄，低体重指数，增加心力衰竭患病率和血红蛋白和肌酐的较低间隙（所有P <0.05）。在随访期间，第三次效率的主要出血，心血管事件和全因死亡率的发生率（所有P <0.05）显着高。多变量调节后，第三型泰利物与心血管事件独立相关（HR 1.72; 95％CI 1.31-2.25）和全因死亡率（HR 1.43; 95％CI 1.06-1.95）。将FIB4索引添加到具有CHA 2 DS 2 -VASC评分的基线模型，改善了心血管事件的预测和全因死亡率，如C统计（所有P <0.05）的显着增加所示，净重新分类改善（所有P <0.001），并综合辨别改善（所有P <0.001）。 FIB4指数≥2.51与心血管事件最强烈相关的≥2.51和AF患者的心血管事件以及高乍得2分数的患者（所有P <0.001）。结论：FIB4指数与AF患者的心血管事件风险与心血管事件的风险无关。

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