FIB-4 stage of liver fibrosis is associated with incident heart failure with preserved, but not reduced, ejection fraction among people with and without HIV or hepatitis C

• Published in: Progress in cardiovascular diseases 2020-03, Vol.63 (2), p.184-191
• Main Authors: So-Armah, Kaku A., Lim, Joseph K., Lo Re, Vincent, Tate, Janet P., Chang, Chung-Chou H., Butt, Adeel A., Gibert, Cynthia L., Rimland, David, Marconi, Vincent C., Goetz, Matthew Bidwell, Ramachandran, Vasan, Brittain, Evan, Long, Michelle, Nguyen, Kim-Lien, Rodriguez-Barradas, Maria C., Budoff, Matthew J., Tindle, Hilary A., Samet, Jeffrey H., Justice, Amy C., Freiberg, Matthew S.
• Format: Article
• Language: English
• Subjects: Cohort; Ejection fraction; Heart failure; Hepatitis; HIV; Liver fibrosis
• ISSN: 0033-0620; 1532-8643; 1873-1740
• DOI: 10.1016/j.pcad.2020.02.010

Liver fibrosis, is independently associated with incident heart failure (HF). Investigating the association between liver fibrosis and type of HF, specifically HF with reduced ejection fraction (EF; HFrEF) or HF with preserved ejection fraction (HFpEF), may provide mechanistic insight into this association. We sought to determine the association between liver fibrosis score (FIB-4) and type of HF, and to assess whether HIV or hepatitis C status modified this association. We included patients alive on or after 4/1/2003 from the Veterans Aging Cohort Study. We followed patients without prevalent cardiovascular disease until their first HF event, death, last clinic visit, or 9/30/2015. We defined liver fibrosis as: likely advanced fibrosis (FIB-4 > 3.25), indeterminate (FIB-4 range 1.45–3.25), unlikely advanced fibrosis (FIB-4