# The FIB-4 Index Is Independently Associated with QTc Interval in Patients with Ankylosing Spondylitis

## TL;DR

This study finds that a noninvasive liver fibrosis marker called FIB-4 is linked to heart rhythm changes in patients with ankylosing spondylitis.

## Contribution

The study is the first to show an independent association between the FIB-4 index and QTc interval in patients with ankylosing spondylitis.

## Key findings

- The FIB-4 index was independently associated with QTc interval in AS patients.
- Sex and FIB-4 index were the only factors remaining significant in multivariable analysis for QTc.

## Abstract

Objective: Prolongation of the QTc interval (QTc) is a known risk factor for ventricular arrhythmias and sudden cardiac death (SCD). Although ankylosing spondylitis (AS) is associated with systemic inflammation and metabolic alterations, data on the relationship between noninvasive fibrosis markers and QTc are limited. This study aimed to investigate the association between the FIB-4 index and QTc in patients with AS. Methods: A total of 82 consecutive patients with AS were enrolled in the study. Demographic characteristics, comorbidities, laboratory parameters, and medication use were also recorded. The FIB-4 index was calculated for each patient in the study. Surface 12-lead electrocardiograms were obtained, and the QTc was measured. Correlation analyses and multivariable linear regression models were used to identify the independent predictors of QTc. Results: The mean age of the study population was 42.4 ± 11.7 years, and 57.3% of the patients were men. Correlation analysis revealed significant associations between QTc and age, sex, the FIB-4 index, body mass index (BMI), hypertension, hyperlipidemia, and cardiovascular medication use, whereas hemoglobin and estimated glomerular filtration rate (eGFR) were negatively correlated with QTc. In the multivariable analysis, only sex (β = −0.306, p = 0.001) and the FIB-4 index (β = 0.379, p < 0.001) remained independently associated with QTc. Conclusion: Our findings demonstrate that the FIB-4 index is independently associated with the QTc in patients with AS. These results suggest that noninvasive fibrosis markers may provide additional insights into cardiovascular risk stratification in this population.