Potential Prognostic Role of Fibrosis-5 Index (FIB-5) in Heart Failure; a Narrative Review

The Fibrosis-5 (FIB-5) index, a non-invasive marker of liver fibrosis, has emerged as a significant prognostic tool in heart failure (HF). Studies indicate that lower FIB-5 values are associated with worse outcomes, including major adverse cardiac and cerebral events (MACCEs), poor response to therapies like cardiac resynchronization therapy (CRT), and increased mortality. The index’s ability to integrate hepatic and systemic dysfunction offers insights into the interplay between liver and heart health, particularly in advanced HF and acute decompensated HF. Combining FIB-5 with inflammatory markers like C-reactive protein improves risk stratification accuracy, suggesting a synergistic value in prognosis. Its predictive capacity for CRT response underscores its clinical relevance beyond hepatic assessment. However, questions remain about the incremental benefit of FIB-5 over established markers and its potential prognostic implications. Future research should focus on validating its utility in diverse HF populations and exploring its role in guiding strategies.