Scientific Sessions 2025  /  Cutting Edge Cardiomyopathies Clinical Research  /  Liver fibrosis as assessed by the fibrosis-5 (FIB-5) index in patients with heart failure: Insights from the PARADIGM-HF and PARAGON-HF trials
Logo

American Heart Association

  139
  0

Final ID: MP1033

Liver fibrosis as assessed by the fibrosis-5 (FIB-5) index in patients with heart failure: Insights from the PARADIGM-HF and PARAGON-HF trials

Abstract Body (Do not enter title and authors here): Background: By causing systemic venous congestion and hypoperfusion, heart failure can lead to liver dysfunction and these processes along with neurohumoral activation, inflammation, and metabolic dysfunction may lead to liver fibrosis. The fibrosis-5 (FIB-5) index, which incorporates serum albumin, alkaline phosphatase, aspartate transaminase, alanine aminotransferase and platelet count, is a marker of possible liver fibrosis. We evaluated the prevalence of an abnormal FIB-5 index in heart failure with reduced ejection fraction (HFrEF), compared with (HFpEF), and the association between FIB-5 index and outcomes in these two types of HF.

Research Questions: What is the prognostic value of the FIB-5 index in patients with HF across the range of left ventricular ejection fraction (LVEF)?

Methods: The PARADIGM-HF and PARAGON-HF trials were randomized, double-blind, active treatment-controlled trials which included 8442 HFrEF patients and 4822 HFpEF patients, respectively. The primary endpoint examined in this analysis was the composite of HF hospitalization or cardiovascular (CV) death. We compared outcomes according to quartiles of FIB-5 index. A low FIB-5 index is associated with hepatic fibrosis.

Results: Overall, 44% of HFrEF patients and 42% of HFpEF patients had possible liver fibrosis as identified by a FIB-5 index <0 (which is reported to have a high specificity, positive predictive value, and negative predictive value for liver fibrosis in other diseases). Lower FIB-5 index was associated with adverse outcomes in both HF phenotypes (Figures). Comparing Quartile 1 to Quartile 4 of the FIB-5 index, gave a hazard ratio (HR) for the primary endpoint of 1.87 (95% CI 1.64-2.13) in PARADIGM-HF and 1.55 (95% CI 1.32-1.83) in PARAGON-HF. The corresponding HRs for CV death were 1.90 (95% CI 1.61–2.23) in PARADIGM-HF and 1.70 (95% CI 1.23-2.3) in PARAGON-HF. The benefit of sacubitril/valsartan was not modified by FIB-5 index.

Conclusion: The FIB-5 index suggests liver fibrosis is common in both HFrEF and HFpEF and is prognostically important, regardless of ejection fraction phenotype.
  • Thanh Anh Pham, Dinh  ( BHF CARDIOVASCULAR RESEARCH CENTRE , Glasgow , United Kingdom )
  • Yang, Mingming  ( BHF CARDIOVASCULAR RESEARCH CENTRE , Glasgow , United Kingdom )
  • Kalayci, Arzu  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Henderson, Alasdair David  ( BHF CARDIOVASCULAR RESEARCH CENTRE , Glasgow , United Kingdom )
  • Anand, Inder  ( VA SAN DIEGO HEATHCARE SYSTEM , La Jolla , California , United States )
  • Desai, Akshay  ( BRIGHAM WOMENS HOSPITAL , Boston , Massachusetts , United States )
  • Maggioni, Aldo Pietro  ( Heart Care Foundation , Firenze , Italy )
  • Martinez, Felipe  ( INSTITUTO DAMIC , Cordoba , Argentina )
  • Pfeffer, Marc  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Rouleau, Jean  ( Montreal Heart Institute , Montreal , Quebec , Canada )
  • Swedberg, Karl  ( Department of Emergency and Cardiovascular Medicine , Groningen , Netherlands )
  • Vaduganathan, Muthiah  ( Brigham and Womens Hospital , Boston , Massachusetts , United States )
  • Van Veldhuisen, Dirk  ( University Hospital Groningen , Groningen , Netherlands )
  • Zannad, Faiez  ( CVCT and Universite de Lorraine , Paris , France )
  • Zile, Michael  ( MEDICAL UNIV OF SOUTH CAROLINA , Charleston , South Carolina , United States )
  • Packer, Milton  ( BAYLOR HEART AND VASCULAR INSTITUTE , Dallas , Texas , United States )
  • Rizkala, Adel  ( Novartis Pharmaceuticals Corporation , East Hanover , New Jersey , United States )
  • Jhund, Pardeep  ( BHF CARDIOVASCULAR RESEARCH CENTRE , Glasgow , United Kingdom )
  • Solomon, Scott  ( Brigham and Women's Hospital , Boston , Massachusetts , United States )
  • Mcmurray, John  ( BHF CARDIOVASCULAR RESEARCH CENTRE , Glasgow , United Kingdom )
    • Author Disclosures:
    Dinh Thanh Anh Pham: DO NOT have relevant financial relationships | Jean Rouleau: DO have relevant financial relationships ; Consultant:Alexion:Active (exists now) ; Consultant:Novo Nordisk:Past (completed) ; Consultant:Amgen:Active (exists now) ; Consultant:Novartis:Active (exists now) ; Consultant:AstraZeneca:Active (exists now) ; Consultant:BAYER:Active (exists now) ; Consultant:BMS:Active (exists now) ; Consultant:Intellia:Active (exists now) | Karl Swedberg: No Answer | Muthiah Vaduganathan: DO have relevant financial relationships ; Consultant:American Regent, Amgen, AstraZeneca, Bayer AG, Baxter Healthcare, Bristol Myers Squibb, Boehringer Ingelheim, Chiesi, Cytokinetics, Esperion, Fresenius Medical Care, Idorsia Pharmaceuticals, Lexicon Pharmaceuticals, Merck, Milestone Pharmaceuticals, Novartis, Novo Nordisk, Pharmacosmos, Relypsa, Roche Diagnostics, Sanofi and Tricog Health:Active (exists now) ; Research Funding (PI or named investigator):Amgen, AstraZeneca, Boehringer Ingelheim, Galmed, Novartis, Bayer AG, Occlutech, Pharmacosmos, and Impulse Dynamics:Active (exists now) | Dirk van Veldhuisen: No Answer | Faiez ZANNAD: DO have relevant financial relationships ; Advisor:Alnylam, Bayer, Biopeutics, Boehringer, Cellprothera, Centrix, Cereno, Centrix Corteria, CVRx, Lilly, Lupin, Merck, NovoNordisk, Opalia Recordati, Owkin, Polygon, Ribocure, Roche, Viatris,:Active (exists now) ; Ownership Interest:Polygon, Cereno pharmaceutical, CVCT:Active (exists now) | Michael Zile: DO NOT have relevant financial relationships | Milton Packer: DO have relevant financial relationships ; Consultant:Lilly:Active (exists now) ; Consultant:v-Wave:Past (completed) ; Consultant:Noco Nordisk:Past (completed) ; Consultant:AstraZeneca:Past (completed) ; Consultant:ARMGO:Active (exists now) ; Consultant:Novartis:Past (completed) ; Consultant:Regeneron:Active (exists now) ; Consultant:Attralus:Active (exists now) ; Consultant:Biopeutics:Past (completed) ; Consultant:Salamandra:Past (completed) ; Consultant:Pharmacocosmos:Past (completed) ; Consultant:Altimmune:Active (exists now) ; Consultant:Amgen:Past (completed) ; Consultant:Abbvie:Past (completed) | Adel Rizkala: DO have relevant financial relationships ; Employee:Novartis:Active (exists now) ; Individual Stocks/Stock Options:Novartis:Active (exists now) | Pardeep Jhund: DO have relevant financial relationships ; Consultant:AstraZeneca:Active (exists now) ; Other (please indicate in the box next to the company name):Director GCTP :Active (exists now) ; Researcher:Analog Devices :Active (exists now) ; Researcher:Roche Diagnostics:Active (exists now) ; Researcher:AstraZeneca:Past (completed) ; Researcher:Boheringer Ingelheim:Past (completed) ; Consultant:Bayer:Active (exists now) | Scott Solomon: DO have relevant financial relationships ; Research Funding (PI or named investigator):Alexion, Alnylam, Applied Therapeutics, AstraZeneca, Bellerophon, Bayer, BMS, Boston Scientific, Cytokinetics, Edgewise, Eidos/BridgeBio, Gossamer, GSK, Ionis, Lilly,NIH/NHLBI, Novartis, NovoNordisk, Respicardia, Sanofi Pasteur, Tenaya, Theracos, US2.AI:Active (exists now) ; Consultant:Abbott, Action, Akros, Alexion, Alnylam, Amgen, Arena, Askbio, AstraZeneca, Bayer, BMS, Cardior, Cardurion, Corvia, Cytokinetics, GSK, Intellia, Lilly, Novartis, Roche, Theracos, Quantum Genomics, Tenaya, Sanofi-Pasteur, Dinaqor, Tremeau, CellProThera, Moderna, American Regent, Sarepta, Lexicon, Anacardio, Akros, Valo, Synhale, Recordati:Active (exists now) | Mingming Yang: DO NOT have relevant financial relationships | John McMurray: DO NOT have relevant financial relationships | ARZU KALAYCI: DO NOT have relevant financial relationships | Alasdair Henderson: DO have relevant financial relationships ; Consultant:Bayer:Active (exists now) | Inder Anand: No Answer | Akshay Desai: DO have relevant financial relationships ; Research Funding (PI or named investigator):Abbott:Past (completed) ; Consultant:River2Renal:Active (exists now) ; Consultant:Roche:Active (exists now) ; Consultant:Regeneron:Active (exists now) ; Consultant:New Amsterdam:Active (exists now) ; Consultant:Novartis:Past (completed) ; Consultant:Merck:Past (completed) ; Consultant:Medtronic:Past (completed) ; Consultant:Medpace:Active (exists now) ; Consultant:GlaxoSmithKline:Past (completed) ; Consultant:Endotronix:Active (exists now) ; Consultant:CVS:Active (exists now) ; Consultant:Boston Scientific:Active (exists now) ; Researcher:Biofourmis:Active (exists now) ; Consultant:Bayer:Active (exists now) ; Consultant:Axon Therapies:Past (completed) ; Consultant:Avidity Biopharma:Active (exists now) ; Consultant:AstraZeneca:Active (exists now) ; Consultant:Alnylam:Active (exists now) ; Consultant:Abbott:Active (exists now) ; Research Funding (PI or named investigator):Pfizer:Active (exists now) ; Research Funding (PI or named investigator):Novartis:Past (completed) ; Research Funding (PI or named investigator):Bayer:Active (exists now) ; Research Funding (PI or named investigator):AstraZeneca:Active (exists now) ; Research Funding (PI or named investigator):Alnylam:Active (exists now) | Aldo Pietro Maggioni: DO have relevant financial relationships ; Other (please indicate in the box next to the company name):AstraZeneca personal fees for participation in studies committees:Active (exists now) ; Other (please indicate in the box next to the company name):Sanofi personal fees for participation in studies committees:Active (exists now) ; Other (please indicate in the box next to the company name):Novartis personal fees for participation in studies committees:Active (exists now) ; Other (please indicate in the box next to the company name):Bayer personal fees for participation in studies committees:Active (exists now) | Felipe Martinez: No Answer | Marc Pfeffer: No Answer
Meeting Info:

Scientific Sessions 2025

2025

New Orleans, Louisiana

Session Info:

Cutting Edge Cardiomyopathies Clinical Research

Saturday, 11/08/2025 , 09:15AM - 10:30AM

Moderated Digital Poster Session

More abstracts on this topic:
Assessing the Role of Charlson Comorbidity Index in Predicting Mortality Among Patients Requiring Rapid Response Team within 24 Hours of Admission

Salamatbad Gidon, Palati Sai, Lin Kuan-yu, Leung Christian, Wang Cassie, Jassal Ajay, Li Shuojohn, Guntaka Saimanoj, Chang Joshua, Jnani Jack, Patel Pushpendra, Cyr Andrew, Weintraub Spencer, Griffin Matthew, Alvarez Villela Miguel, Pierce Matthew, Shknevskiy Shusterman Vlad, Bhatt Madhav, Suleman Saman, Nuvvula Sri, Lin Allan, Dahal Kripa, Elkhechen Nader

β1-adrenergic autoantibodies (β1-AA) augment macropinocytosis in CD4+ T cells, leading to the expansion of CD4+CD28− T cell subsets in heart failure.

Sun Fei, Yao Junyan, Li Bingjie, Zhang Suli, Liu Huirong

More abstracts from these authors:
Lipid Profiles and Prognosis in Heart Failure: A Participant-Level Pooled Analysis of the PARADIGM-HF and PARAGON-HF Trials

Siqueira Sara, Jhund Pardeep, Mcmurray John, Vaduganathan Muthiah, Solomon Scott, Pabon Maria, Claggett Brian, Packer Milton, Lam Carolyn, Rouleau Jean, Zile Michael, Lefkowitz Marty, Desai Akshay

Age, Adiposity-Related Anthropometrics, and Clinical Outcomes in Heart Failure with Mildly Reduced or Preserved Ejection Fraction: A Participant-Level Pooled Analysis of Randomized Trials

Ostrominski John, Pitt Bertram, Zannad Faiez, Zile Michael, Mcmurray John, Solomon Scott, Vaduganathan Muthiah, Lassen Mats, Butt Jawad, Claggett Brian, Anand Inder, Desai Akshay, Jhund Pardeep, Lam Carolyn, Pfeffer Marc

4365699_File000000.jpg
4365699_File000000.jpg
4365699_File000001.jpg
4365699_File000001.jpg
You have to be authorized to contact abstract author. Please, Login
Not Available