Liver fibrosis assessed with transient elastography is an independent risk factor for ischemic stroke

• Published in: Atherosclerosis Vol. 260; pp. 156 - 162
• Main Authors: Kim, Seung Up, Song, Dongbeom, Heo, Ji Hoe, Yoo, Joonsang, Kim, Beom Kyung, Park, Jun Yong, Kim, Do Young, Ahn, Sang Hoon, Kim, Kwang Joon, Han, Kwang-Hyub, Kim, Young Dae
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.05.2017
• Subjects: Acute Disease; Biopsy; Body Mass Index; Brain - diagnostic imaging; Brain Ischemia - diagnosis; Brain Ischemia - epidemiology; Brain Ischemia - etiology; Cardiovascular; Elasticity Imaging Techniques - methods; Female; Follow-Up Studies; Humans; Incidence; Liver - diagnostic imaging; Liver Cirrhosis - complications; Liver Cirrhosis - diagnostic imaging; Liver stiffness; Magnetic Resonance Imaging; Male; Middle Aged; Odds Ratio; Prognosis; Republic of Korea - epidemiology; Retrospective Studies; Risk Assessment; Risk Factors; Stroke; Tomography, X-Ray Computed; Transient elastography; Stroke; Liver stiffness; Transient elastography; Risk factors
• ISSN: 0021-9150; 1879-1484; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2017.02.005

The relationship between liver fibrosis and the occurrence of ischemic stroke is unknown. We investigated the correlation between liver fibrosis assessed with transient elastography (TE) and the risk of ischemic stroke. Between April 2013 and August 2014, patients with acute ischemic stroke and subjects who underwent a health check-up were included in the study. Liver fibrotic burden was assessed with TE in all participants. The degree of liver fibrosis was compared between groups by using various multiple logistic regression models and propensity-score matched analyses. Two hundred ninety-five patients with ischemic stroke (stroke group) and 1942 subjects with health check-up (control group) were included. The mean liver stiffness (LS) on TE (5.6 vs. 4.1 kPa) and the proportion of significant fibrosis (>8 kPa) (9.2% vs. 1.8%) were significantly higher in the stroke than in the control group (all p<0.05). These trends were observed regardless of body mass index, the degree of hepatic steatosis, and metabolic syndrome (all p<0.05). The adjusted odds ratio (OR) for ischemic stroke was 1.268 (95% confidence intervals [CI] 1.183–1.358) per 1 kPa increase and 12.033 (95% CI 5.180–27.948) for significant fibrosis, compared with no fibrosis (all p < 0.05). Propensity-score matched analysis also confirmed that liver fibrosis was independently associated with the risk of ischemic stroke (OR 1.804 [95% CI 1.461–2.230] per 1 kPa increase, 13.184 [95% CI 3.127–55.645] for significant fibrosis, compared with no fibrosis; all p<0.001). The degree of liver fibrosis, assessed with TE, was significantly associated with the risk of ischemic stroke. •We studied the relationship between liver fibrosis and stroke risk using TE.•Liver fibrotic burden was significantly associated with the risk of ischemic stroke.•This association was maintained regardless of liver steatosis or metabolic syndrome.