Title:Hepatic Fibrosis Predicts the Prognosis of Patients with Acute Ischemic Stroke Through the Mediation of Cardioembolism
Volume: 24
Issue: 1
Author(s): Mingyue Zhao, Jiexi Huang, Tian Zeng, Minyue Zhang, Jiaqi Huang, Yufan Gao, Haobo Xie, Shengqi Li, Yilin Chen, Jiahan Xu, Yanchu Wang, Shenyi Lin, Yiyun Weng*Guangyong Chen*
Affiliation:
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Keywords:
Cardioembolism, stroke, hepatic fibrosis, CE etiology, aminotransferase-platelet, acute ischemic stroke.
Abstract:
Background: Hepatic fibrosis, a chronic pathological condition, is associated with adverse
outcomes in stroke patients. Cardioembolism (CE) is a common etiology of stroke, yet the association
between hepatic fibrosis and CE remains understudied.
Aims: This study aims to investigate the association between hepatic fibrosis and CE-induced stroke,
as well as its impact on stroke patient prognosis.
Methods: This retrospective study included 344 acute ischemic stroke (AIS) patients who underwent
thrombolytic therapy. Hepatic fibrosis was assessed using the Fibrosis-4 (FIB-4) index and the Aspartate
Aminotransferase-Platelet Ratio Index (APRI). Mediation analysis examined the role of CE in
the association between hepatic fibrosis and 3-month functional outcomes.
Results: Among 344 patients, 319 were classified using the Trial of Org 10172 in Acute Stroke
Treatment criteria. Severe fibrosis (FIB-4 ≥ 2.01) was observed in 131 patients (38.08%), and CE
was identified in 79 patients. FIB-4 was an independent predictor of CE (OR: 2.038, 95%CI: 1.507-
2.757, p < 0.001) and poor 3-month functional outcome (OR: 1.477, 95%CI: 1.103-1.978, p = 0.009)
after adjusting for confounders. The effect of FIB-4 on poor 3-month functional outcomes was partially
mediated by CE, with a mediation proportion of 30.63%.
Conclusion: Hepatic fibrosis is a significant predictor of short-term functional outcomes in AIS,
particularly cardioembolic stroke. The association between hepatic fibrosis and stroke outcomes is
partially mediated through CE. These findings highlight the importance of assessing hepatic fibrosis
in stroke patients, particularly those with CE etiology.
