Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Cerebrovasc Dis. 2019;47(1-2):32-39. doi: 10.1159/000497069. Epub 2019 Feb 14.
To investigate whether there are differences in long-term all-cause and cardiovascular mortality according to the burden of liver fibrosis or steatosis in patients with ischaemic stroke or transient ischaemic attack (TIA). -Methods: Consecutive patients with acute ischaemic stroke or TIA who underwent transient elastography (TE) from January 2014 to December 2014 were considered eligible. The influence of liver fibrosis or steatosis, assessed via TE, on long-term outcomes was investigated using Cox proportional hazard models.
Among 395 patients included in this study, there were 37 (9%) patients with significant fibrosis (> 8.0 kPa) and 164 (41.5%) patients with fatty liver (> 250 dB/m). During the follow-up period (median 2.7 years), all-cause and cardiovascular mortality occurred in 28 (7.1%) and 20 (5.1%) patients. On multivariate analyses, significant liver fibrosis was independently associated with increased risk of all-cause (hazard ratio [HR] 8.14, 95% CI 3.03-21.90, p < 0.001) and cardiovascular (HR 4.29, 95% CI 1.10-16.73, p = 0.036) mortality, whereas fatty liver was not (all p > 0.05).
This study found that the burden of liver fibrosis but not that of steatosis, assessed via TE, was an independent predictor of all-cause and cardiovascular mortality during long-term follow-up in patients with ischaemic stroke.
为了探究在缺血性卒中和短暂性脑缺血发作(TIA)患者中,根据肝纤维化或脂肪变性的负担,是否存在长期全因和心血管死亡率的差异。
本研究纳入了 2014 年 1 月至 2014 年 12 月期间接受瞬时弹性成像(TE)的急性缺血性卒中和 TIA 连续患者。使用 Cox 比例风险模型研究 TE 评估的肝纤维化或脂肪变性对长期结局的影响。
在本研究中,纳入的 395 例患者中,有 37 例(9%)患者存在显著纤维化(> 8.0 kPa),164 例(41.5%)患者存在脂肪肝(> 250 dB/m)。在随访期间(中位数为 2.7 年),28 例(7.1%)和 20 例(5.1%)患者发生全因和心血管死亡率。多变量分析显示,显著的肝纤维化与全因(风险比 [HR] 8.14,95%CI 3.03-21.90,p < 0.001)和心血管(HR 4.29,95%CI 1.10-16.73,p = 0.036)死亡率的增加独立相关,而脂肪肝则不然(所有 p > 0.05)。
本研究发现,通过 TE 评估的肝纤维化负担而不是脂肪变性负担,是缺血性卒中患者长期随访中全因和心血管死亡率的独立预测因素。