Abstract 15289: Association Between Liver Stiffness and Prevalence of Stroke: Analysis of the National Health and Nutrition Examination Survey 2017 - 2020

Abstract

Introduction: While cirrhotic patients increase risk of hemorrhagic and thrombotic events, association of liver stiffness with stroke remaines unclear. Hypothesis: Severity of liver stiffness is associated with higher prevalence of stroke. Methods: A cross-sectional study using the National Health and Nutrition Examination Survey (NHANES) 2017 to March 2020 included adult participants aged 21 to 79 years. Association between prevalence of self-reported stroke and liver stiffness stratified for 4 fibrosis scores measured by Fibroscan ™ were analyzed by multivariate logistic regression. Results: A total of 8,416 patients with Fibroscan results were identified (mean age 49 + 16 years old; 52% female; 32% white). Overall, 377 patients (4.5%) had a stroke. The number of participants stratified by 4 fibrotic stages of mild (F0F1), moderate (F2), severe fibrosis (F3), and cirhosis (F4) were 6,243 (74.2%), 826 (9.8%), 122 (1.4%), and 155 (1.8%) patients, respectively. In multivariate logistic regression, after controlling for age, race, gender, diabetic status, body mass index (<25 vs > 25 kg/m 2 ), and high systolic blood pressure ( < 130 vs >130 mmHg), individuals with severe fibrotic liver (F3 and F4) were significantly more likely to have a stroke (adjusted odds ratio (OR) 1.64; p= 0.044; 95% confidence interval (CI) 1.01, 2.65; Figure 1). Furthermore, we found that patients with cirrhosis (F4) were the most at risk to have a stroke (adjusted OR 1.91; p= 0.037; 95% CI 1.04, 3.49; Figure 1). Conclusions: In this cross-sectional data, there is a graded association between severe fibrotic liver disease measured by Fibroscan ™ and elevated prevalence of stroke. Longitudinal studies including additional risk factors of stroke such as hyperlipidemia, hypertension and atrial fibrillation need to be further evaluated.