Evidence map›Paper›PMID 35485970›Full record

ArticleEuropean journal of neurology2022

Liver Fibrosis-4 index indicates atrial fibrillation in acute ischemic stroke.

Simon Fandler-Höfler, Markus Kneihsl, Rudolf E Stauber, Egbert Bisping, Harald Mangge, Gerit Wünsch, Melanie Haidegger, Linda Fabisch, Isra Hatab, Peter Fickert and 3 more

Open access · hybridAbstract read
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In one paragraph

Article in European journal of neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
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  3. Article
  4. Article
  5. Article
  6. Review
  7. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 2 countries.

Simon Fandler-HöflerDepartment of Neurology, Medical University of Graz, Graz, Austria.ORCID 0000-0001-9043-0378
Markus KneihslDepartment of Neurology, Medical University of Graz, Graz, Austria.ORCID 0000-0002-6334-9432
Rudolf E StauberDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Egbert BispingDivision of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Harald ManggeClinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
Gerit WünschInstitute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria.
Melanie HaideggerDepartment of Neurology, Medical University of Graz, Graz, Austria.
Linda FabischDepartment of Neurology, Medical University of Graz, Graz, Austria.
Isra HatabDepartment of Neurology, Medical University of Graz, Graz, Austria.
Peter FickertDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
David WerringStroke Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK.
Christian EnzingerDepartment of Neurology, Medical University of Graz, Graz, Austria.
Thomas GattringerDepartment of Neurology, Medical University of Graz, Graz, Austria.ORCID 0000-0002-6065-6576
Medical University of Graz · ATQueen Mary University of London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNon-alcoholic fatty liver disease and particularly liver fibrosis are related to cardiovascular disease and may indicate an increased risk for atrial fibrillation (AF), but this association has not yet been systematically investigated in a cohort of ischemic stroke patients.

methodsWe analyzed data from a prospective single-center study enrolling all consecutive ischemic stroke patients admitted to our stroke unit over a 1-year period. All patients received a thorough etiological workup. For evaluation of liver fibrosis, we determined the Fibrosis-4 (FIB-4) index, a well-established noninvasive liver fibrosis test. Laboratory results were analyzed from a uniform blood sample taken at stroke unit admission.

resultsOf 414 included patients (mean age 70.2 years, 57.7% male), FIB-4 indicated advanced liver fibrosis in 92 (22.2%). AF as the underlying stroke mechanism was present in 28.0% (large vessel disease: 25.6%, small vessel disease: 11.4%, cryptogenic: 29.2%). Patients with FIB-4 ≥ 2.67 had higher rates of AF (53.3% vs. 20.8%, p < 0.001), and this association remained significant after correction for established AF risk factors (odds ratio 2.53, 95% confidence interval 1.44-4.46, p = 0.001). FIB-4 was further associated with worse functional outcome 3 months (p < 0.001) and higher mortality 4 years post-stroke (p < 0.02), but these relationships were no longer present after correction for age and initial stroke severity. Moreover, FIB-4 was not associated with long-term recurrent vascular events.

conclusionsLiver fibrosis assessed by the FIB-4 index is independently associated with AF in acute ischemic stroke patients. Further studies should evaluate whether adding the FIB-4 index to AF risk scores increases their precision.

Indexed as

Atrial FibrillationIschemic StrokeStrokeAgedFemaleHumansLiver CirrhosisMaleProspective StudiesRisk Factorsatrial fibrillationischemic strokeliver fibrosis

Identifiers

PMID35485970
PMCPMC9545754
OpenAlexW4225096150

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.