ArticleInternational journal of general medicine2025
Association Between Liver Fibrosis Markers and Hemorrhagic Transformation Following Endovascular Treatment for Acute Ischemic Stroke: A Chinese Stroke Center Study.
Article in International journal of general medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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7 authors.
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Abstract
Purpose: To investigate the association between non-invasive liver fibrosis indices and the risk of hemorrhagic transformation (HT) and symptomatic intracranial hemorrhage (sICH) after endovascular therapy (EVT) in patients with anterior circulation large vessel occlusion (LVO) stroke. Patients and Methods: In this single-center retrospective cohort study, we consecutively enrolled 340 patients with anterior circulation LVO stroke who underwent EVT at a comprehensive stroke center between January 2018 and December 2024. Eight non-invasive liver fibrosis indices were calculated based on fasting laboratory parameters obtained within 24 hours of admission. The primary outcomes were HT and sICH. Multivariable logistic regression and restricted cubic spline analyses were performed to assess the associations. Results: Of the 340 patients, 161 (47.4%) developed HT, and 69 (20.3%) experienced sICH. After adjusting for confounders, elevated fibrosis-4 index (FIB-4) (adjusted odds ratio [aOR]=1.25, 95% CI: 1.01-1.56; aOR=1.48, 95% CI: 1.12-1.94), the modified FIB-4 (aOR1.07, 95% CI: 1.01-1.15; aOR=1.13, 95% CI: 1.04-1.23), the aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AAR) (aOR=1.43, 95% CI: 1.03-1.96; aOR=1.91, 95% CI: 1.16-3.12), and the AST to ALT-platelet ratio index (AARPRI) (aOR=1.53, 95% CI: 1.07-2.17; aOR=2.36, 95% CI: 1.45-3.84) were independently associated with increased risks of both HT and sICH. Conversely, the FIB-5 index showed an inverse association (aOR=0.95, 95% CI: 0.91-1.00; aOR=0.91, 95% CI: 0.85-0.98). These indices demonstrated higher predictive values for sICH (AUC: 0.65-0.70) than for HT (AUC: 0.61-0.62). Notably, patients with parenchymal hematoma had significantly greater liver fibrosis indices than those with hemorrhagic infarction or no hemorrhage (all P<0.05). Conclusion: Non-invasive liver fibrosis indices are independently associated with post-EVT hemorrhagic complications in anterior circulation stroke patients and may serve as readily accessible tools for risk stratification.
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