Tabriz University of Medical Sciences Journal of Cardiovascular and Thoracic Research 2008-5117 18 2 2026 06 30 Association of value of fibrosis-4 index with long-term mortality in patients with heart failure: A comparison study with fibrosis-5 index 103 108 10.34172/jcvtr.33476 EN HALİT EMRE YALVAÇ https://orcid.org/0000-0003-2620-9948 fatih enes durmaz https://orcid.org/0000-0002-9688-110X bektas Murat https://orcid.org/0000-0002-6564-7185 Selda Murat https://orcid.org/0000-0002-3935-0222 Journal Article 10.34172/jcvtr.33476 2025 01 06 2026 02 18 Background Heart failure (HF) is a major global cause of morbidity and mortality. Reliable prognostic markers are essential for guiding long-term management. The Fibrosis-4 (FIB-4) and Fibrosis-5 (FIB-5) indices, initially developed for staging liver fibrosis, have recently been proposed as predictors of cardiovascular outcomes. However, their comparative value in heart failure with reduced ejection fraction (HFrEF) remains unclear. Objectives To assess and compare the prognostic performance of FIB-4 and FIB-5 in predicting long-term mortality in HFrEF patients. Methods This dual-center retrospective study included 593 patients hospitalized with HFrEF between January 2015 and December 2023. The primary endpoint was 5-year all-cause mortality; secondary endpoints included 1-year mortality and hospital readmission. FIB-4 and FIB-5 were calculated from admission laboratory values. Receiver operating characteristic (ROC) analyses and multivariable logistic regression were performed to determine prognostic value. Results Over a median follow-up of 5 years, all-cause mortality was XX%. Both FIB-4 and FIB-5 predicted long-term mortality (AUC: X.XX and X.XX, respectively). In patients aged ≤75 years, FIB-5 showed superior discrimination compared with FIB-4 (AUC 0.662 vs. 0.584, p<0.05). In multivariable analysis adjusted for clinical and echocardiographic variables including right ventricular dysfunction, FIB-5 remained an independent predictor of 5-year mortality (OR 1.05, 95% CI 1.01–1.10, p=0.04). Conclusion FIB-4 and FIB-5 are both associated with mortality in HFrEF. FIB-5 demonstrated greater prognostic strength and independence from right ventricular function, supporting its potential as a practical risk stratification tool.