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Updated: Jun 13, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Is the FIB-4 score a prognostic factor in acute ischemic stroke patients receiving intravenous thrombolytic therapy?
Ege Çadırci1, Mine Hayriye Sorgun1, Kurtuluş Umut Bozkurt1
1Department of Neurology, Ankara University School of Medicine, İbni Sina Hospital, Ankara, Turkey.
Insights
The FIB-4 index, a liver fibrosis marker, predicts poor prognosis in acute ischemic stroke patients treated with IV tPA. Higher FIB-4 scores correlate with increased mortality and worse outcomes.
Area of Science:
- Neurology
- Cardiology
- Hepatology
Background:
- Liver dysfunction is a known risk factor for adverse outcomes post-stroke.
- The FIB-4 index, used for liver fibrosis assessment, shows links to poor prognosis in cardiovascular and cerebrovascular diseases.
- Investigating FIB-4's role in acute ischemic stroke treated with IV tPA is crucial.
Purpose of the Study:
- To explore the association between FIB-4 scores and hemorrhagic transformation, mortality, and prognosis.
- To evaluate the predictive value of FIB-4 in acute ischemic stroke patients receiving intravenous thrombolytic therapy (IV tPA).
Main Methods:
- Retrospective review of 255 patients who received IV tPA for acute ischemic stroke.
- Patients categorized into two groups based on FIB-4 scores (≤2.67 and >2.67).
- Analysis included demographic data, NIHSS, THRIVE, bleeding rates, stroke etiology, and 3-month mRS scores.
Main Results:
- Patients with higher FIB-4 scores (group 2) were older and had significantly higher 3-month mortality and mRS scores.
- While group 2 showed a trend towards increased intracranial hemorrhage, the difference was not statistically significant.
- Logistic regression analysis confirmed FIB-4 as a predictor of adverse outcomes.
Conclusions:
- The FIB-4 index shows potential as a predictor of poor prognosis in acute ischemic stroke patients undergoing IV tPA.
- Further large-scale prospective studies are warranted to validate these findings and inform clinical practice.
- FIB-4 may offer valuable insights for risk stratification and management of stroke patients.
Background:
Liver dysfunction is recognized as a risk factor for poor outcome after. stroke. The FIB-4 index, a laboratory test for predicting liver fibrosis, has been shown to be. associated with poor prognosis in cardiovascular and cerebrovascular diseases. The aim of. this study was to explore the relationship between FIB-4 score and hemorrhagic. transformation, mortality, and prognosis in patients with acute ischemic stroke who received. intravenous thrombolytic therapy (IV tPA).
Methods:
The records of 255 consecutive patients who received IV tPA for acute. ischemic stroke were retrospectively reviewed. Patients were divided into two groups. according to their FIB-4 scores: group 1 (FIB-4 ≤ 2.67) and group 2 (FIB-4 > 2.67). The. demographic data, NIHSS scores at admission, THRIVE scores, intracranial bleeding rates, (using the Heidelberg Bleeding Classification, NINDS and ECASS criteria for symptomatic. intracranial hemorrhage), stroke etiology subtypes (using the automated Causative. Classification System), and mRS scores at the third month were recorded.
Results:
On logistic regression analysis, group 2 patients were older, had higher mRS. scores at the third month and had increased mortality within 3 months when compared with. group 1 (p ≤ 0.05). Although group 2 patients had a higher rate of intracranial hemorrhage, the difference was not statistically significant.
Conclusions:
The FIB-4 index may serve as a a useful predictor of poor prognosis in patients with acute ischemic stroke who received IV tPA. Large-scale prospective studies are needed to confirm this relationship and provide valuable insights for clinical practice.
