Association between elevated fibrosis-4 index of liver fibrosis and risk of hemorrhagic stroke.

IF 5.8 3区医学 Q1 CLINICAL NEUROLOGY

European Stroke Journal Pub Date : 2024-06-13 DOI:10.1177/23969873241259561

Neal S Parikh, Cenai Zhang, Samuel S Bruce, Santosh B Murthy, Russell Rosenblatt, Ava L Liberman, Vanessa Liao, Jed H Kaiser, Babak B Navi, Costantino Iadecola, Hooman Kamel

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引用次数: 0

Abstract

Background: Cirrhosis is associated with an increased risk of hemorrhagic stroke. Liver fibrosis, typically a silent condition, is antecedent to cirrhosis. The objective of this study was to test the hypothesis that elevated Fibrosis-4 (FIB-4) index, indicating a high probability of liver fibrosis, is associated with an increased risk of hemorrhagic stroke.

Methods: We performed a cohort analysis of the prospective United Kingdom Biobank cohort study. Participants 40-69 years old were enrolled between 2007 and 2010 and had available follow-up data until March 1, 2018. We excluded participants with prevalent hemorrhagic stroke or thrombocytopenia. High probability of liver fibrosis was defined as having a value >2.67 of the validated FIB-4 index. The primary outcome was hemorrhagic stroke (intracerebral or subarachnoid hemorrhage), defined based on hospitalization and death registry data. Secondary outcomes were intracerebral and subarachnoid hemorrhage, separately. We used Cox proportional hazards models to evaluate the association of FIB-4 index >2.67 with hemorrhagic stroke while adjusting for potential confounders including hypertension, alcohol use, and antithrombotic use.

Results: Among 452,994 participants (mean age, 57 years; 54% women), approximately 2% had FIB-4 index >2.67, and 1241 developed hemorrhagic stroke. In adjusted models, FIB-4 index >2.67 was associated with an increased risk of hemorrhagic stroke (HR, 2.0; 95% CI, 1.6-2.6). Results were similar for intracerebral hemorrhage (HR, 2.0; 95% CI, 1.5-2.7) and subarachnoid hemorrhage (HR, 2.2; 95% CI, 1.5-3.5) individually.

Conclusions: Elevated FIB-4 index was associated with an increased risk of hemorrhagic stroke.

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肝纤维化-4 指数升高与出血性中风风险之间的关系

背景：肝硬化会增加出血性中风的风险。肝纤维化是肝硬化的先兆，通常是无声的。本研究的目的是检验纤维化-4（FIB-4）指数升高（表明肝纤维化的可能性很高）与出血性中风风险增加相关的假设：我们对英国生物库前瞻性队列研究进行了队列分析。年龄在 40-69 岁之间的参与者于 2007 年至 2010 年间入组，并在 2018 年 3 月 1 日前拥有可用的随访数据。我们排除了患有出血性中风或血小板减少症的参与者。肝纤维化的高概率定义为有效的FIB-4指数值大于2.67。主要结果是出血性中风（脑内出血或蛛网膜下腔出血），根据住院和死亡登记数据定义。次要结果分别为脑内出血和蛛网膜下腔出血。我们使用 Cox 比例危险模型评估了 FIB-4 指数大于 2.67 与出血性中风的关系，同时调整了潜在的混杂因素，包括高血压、饮酒和使用抗血栓药物：在 452994 名参与者（平均年龄 57 岁；54% 为女性）中，约 2% 的人 FIB-4 指数大于 2.67，其中 1241 人发生了出血性中风。在调整模型中，FIB-4 指数大于 2.67 与出血性中风风险增加有关（HR，2.0；95% CI，1.6-2.6）。脑内出血（HR，2.0；95% CI，1.5-2.7）和蛛网膜下腔出血（HR，2.2；95% CI，1.5-3.5）的结果类似：结论：FIB-4 指数升高与出血性中风风险增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Stroke Journal Multiple-

CiteScore

7.50

自引率

6.60%

发文量

102

期刊介绍： Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.