Abstract TP39: Impact Of Silent Liver Fibrosis To Cerebral Microbleeds In Patients With Acute Ischemic Stroke

Abstract

Background: Liver fibrosis (LF) is reported to affect the development of cerebral small vessel disease (SVDs) including cerebral microbleeds (CMBs). The Fibrosis-4 (Fib4) index is a simple and non-invasive scoring method for detecting LF. Herein, we investigated the association between the severity of LF and the presence or distribution of CMBs. Methods: From October 2012 to May 2022, patients with acute ischemic stroke within 24 hours from onset were retrospectively enrolled. Exclusion criteria were those associated with malignancy or missing clinical data including MRI findings before treatment started, or functional outcome at 3 months after discharge. The distribution of CMBs were classified on MRI as strictly lobar, or not (deep/ infratentorial or mixed area). FIB-4 index is calculated as follows: FIB-4 = [age (years)*aspartate aminotransferase (U/L)] / [platelet count (10 9 /L) *√alanine aminotransferase (U/L)]. We analyzed the association between the severity of LF, according to the tertile of Fib4 index; mild-LF (Fib4 index < 1.30), moderate-LF (1.30 ≤ Fib4 index < 2.67), severe-LF (2.67 ≤ Fib4 index), and the presence and distribution of CMBs. Results: 614 subjects (median age 69 years, 435 men) were retrospectively enrolled. Fib4 index were higher in order of only lobar, deep/ infratentorial or mixed area, and none CMBs ( p < 0.001). Also, severe LF group showed the highest number of CMBs (p < 0.001). Age on admission (OR 1.040, 95% CI 1.020-1.050, p < 0.001), hypertension (OR 1.840, 95%CI 1.260-2.690, p = 0.002), and anti-thrombotic drugs using (OR 1.500, 95% CI 1.020-2.190, p = 0.038) were independently associated with the presence of CMBs. In anatomical distribution of CMBs, Fib4 index (OR 0.701, 95%CI 0.505-0.974, p = 0.034) were only independent predictive factor of the CMBs on D/I or mixed area. Conclusion: The novel association between silent LF and the distribution of CMBs as located in only lobar were established.