Prognostic Value of Fibrosis-4 in Acute Ischemic Stroke Patients Undergoing Intravenous Thrombolysis.

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Clinical Interventions in Aging Pub Date : 2024-10-07 eCollection Date: 2024-01-01 DOI:10.2147/CIA.S469899

Hong-Jing Zhu, Sheng-Yu Zhou, Yang Qu, Ying-Ying Sun, Ke-Jia Zhang, Shu-Yan Pang, Yi Yang, Zhen-Ni Guo

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引用次数: 0

Abstract

Purpose: Although recombinant tissue plasminogen activator (rt-PA) treatment is efficient in patients with acute ischemic stroke (AIS), a significant percentage of patients who received rt-PA intravenous thrombolysis (IVT) do not achieve a good prognosis. Therefore, the factors that affect the poor prognosis of patients with IVT are needed. The Fibrosis-4 (FIB-4) index has been used as a liver fibrosis biomarker. We aimed to investigate the relationship between the FIB-4 index and functional outcomes in patients with AIS receiving IVT.

Patients and methods: This study prospectively included consecutive patients with AIS receiving IVT between April 2015 and May 2022. We collected clinical and laboratory data and calculated the FIB-4 index. Clinical outcome was poor functional outcome (mRS ≥3) at 3 months after IVT. Multivariate logistic regression analysis was used to analyze the association between FIB-4 and outcome. We explored the interactive effect of FIB-4 and dyslipidemia on poor outcomes, and subgroup analysis was performed. Furthermore, an individualized prediction model based on the FIB-4 for functional outcome was established in the dyslipidemia group.

Results: A total of 1135 patients were included, and 41.50% had poor 3-month outcomes. After adjusted by other variants that P value <0.05 in univariable analysis, FIB-4 was independently associated with poor outcomes (OR=1.420; 95% CI: 1.113-1.812; P=0.004). There was a significant interaction between FIB-4 and dyslipidemia on poor outcome (P=0.036), and the independent association between FIB-4 and poor outcome was maintained in the dyslipidemia subgroup (OR=1.646; 95% CI: 1.228-2.206; P=0.001). Furthermore, in the dyslipidemia group, the FIB-4-based prediction model had good predictive value (the AUC of the training and validation sets were 0.767 and 0.708, respectively), good calibration (P-values for the Hosmer-Lemeshow test >0.05), and clinical usefulness.

Conclusion: FIB-4 is an independent risk factor for poor outcomes in IVT patients with dyslipidemia, which can be used as a simple predictor of their prognosis.

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接受静脉溶栓治疗的急性缺血性脑卒中患者纤维化-4的预后价值

目的：虽然重组组织纤溶酶原激活剂（rt-PA）治疗急性缺血性卒中（AIS）患者有效，但相当一部分接受过 rt-PA 静脉溶栓（IVT）治疗的患者预后不佳。因此，需要研究影响 IVT 患者不良预后的因素。纤维化-4（FIB-4）指数已被用作肝纤维化生物标志物。我们旨在研究接受 IVT 的 AIS 患者的 FIB-4 指数与功能预后之间的关系：本研究前瞻性地纳入了2015年4月至2022年5月期间接受IVT治疗的连续AIS患者。我们收集了临床和实验室数据，并计算了FIB-4指数。临床结局为IVT后3个月时功能预后不佳（mRS≥3）。我们采用多变量逻辑回归分析来分析FIB-4与预后之间的关系。我们探讨了FIB-4和血脂异常对不良预后的交互影响，并进行了亚组分析。此外，我们还在血脂异常组中建立了基于FIB-4的功能预后个体化预测模型：结果：共纳入 1135 名患者，41.50% 的患者 3 个月后预后不佳。经其他变异因素调整后，P值=0.004）。FIB-4和血脂异常对不良预后有明显的交互作用（P=0.036），在血脂异常亚组中，FIB-4和不良预后之间的独立关联保持不变（OR=1.646；95% CI：1.228-2.206；P=0.001）。此外，在血脂异常组中，基于FIB-4的预测模型具有良好的预测价值（训练集和验证集的AUC分别为0.767和0.708）、良好的校准性（Hosmer-Lemeshow检验的P值>0.05）和临床实用性：结论：FIB-4是导致血脂异常IVT患者不良预后的一个独立风险因素，可作为其预后的一个简单预测指标。

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

Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-

CiteScore

6.80

自引率

2.80%

发文量

193

审稿时长

6-12 weeks

期刊介绍： Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.