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Updated: May 23, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

FIB-4 Index, Systemic Inflammation, and Troponin Trajectory After Endovascular Thrombectomy in Older Patients with

Wenjie Chen1, Yahang Tan1, Xuesong Bai2

  • 1Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China.

Clinical Interventions in Aging
|May 22, 2026
PubMed

Insights

The Fibrosis-4 (FIB-4) index and C-reactive protein (CRP) indicate higher myocardial injury risk after large-vessel occlusion acute ischemic stroke (LVO-AIS). Dynamic myocardial injury predicts increased 90-day mortality in these stroke patients.

Area of Science:

  • Cardiology
  • Neurology
  • Biochemistry

Background:

  • Stroke-heart syndrome complicates prognosis in large-vessel occlusion acute ischemic stroke (LVO-AIS).
  • The Fibrosis-4 (FIB-4) index may indicate metabolic vulnerability, but its link to post-stroke myocardial injury and inflammation's role is unclear.

Purpose of the Study:

  • To investigate the association between the FIB-4 index, C-reactive protein (CRP), and myocardial injury in LVO-AIS patients.
  • To explore the modifying effect of systemic inflammation on the FIB-4 index-myocardial injury relationship.
  • To assess the association between myocardial injury patterns and 90-day mortality.

Main Methods:

  • Retrospective cohort study of 448 patients (≥60 years) with anterior-circulation LVO-AIS treated with endovascular thrombectomy.
  • Cardiac troponin I levels measured at admission and 48 hours to classify troponin trajectory (no, non-dynamic, or dynamic myocardial injury).
  • Ordinal and binary logistic regression analyses used to assess associations of FIB-4, CRP, and 90-day mortality.

Main Results:

  • Higher FIB-4 index and elevated CRP were significantly associated with more severe troponin trajectories.
  • Systemic inflammation (indicated by CRP) modified the association between high FIB-4 and troponin trajectory.
  • Dynamic myocardial injury was linked to a substantially increased risk of 90-day mortality.

Conclusions:

  • Elevated FIB-4 index and CRP levels are associated with increased myocardial injury severity in LVO-AIS patients.
  • Systemic inflammation plays a role in the relationship between FIB-4 and myocardial injury.
  • Identifying dynamic myocardial injury is crucial for predicting mortality risk in LVO-AIS.
Abstract

Keywords:
C-reactive proteinacute ischemic strokeendovascular thrombectomyfib-4 indexstroke-heart syndrome

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