{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:32:54Z","timestamp":1793413974609,"version":"4.5.0"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,2,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">There is a well\u2010established relationship between liver conditions and cardiovascular diseases. However, uncertainty persists regarding the contribution of liver fibrosis to major stroke types including ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage at the population level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this large prospective cohort study, participants without previous stroke or coronary heart disease at baseline from the UK Biobank were included. We identified participants at high probability of advanced liver fibrosis using the Fibrosis\u20104 index &gt;2.67 or aspartate aminotransferase to platelet ratio index \u22651.0. Multivariable Cox proportional hazard regression analyses were conducted to estimate hazard ratios (HRs) for liver fibrosis with the incidence of major stroke types, stroke\u2010related death, and all\u2010cause death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among 379\u2009953 participants (mean age, 56.2 [SD, 8.1] years; 44.6% men), 7396 (1.9%) had a Fibrosis\u20104 index &gt;2.67 at baseline. During a median follow\u2010up of 12.75 (interquartile range, 12.03\u201313.48) years, 7143 (1.9%) incident stroke cases were documented. Advanced liver fibrosis assessed by the Fibrosis\u20104 index was associated with an increased risk of ischemic stroke (HR, 1.94 [95% CI, 1.70\u20132.22]), intracerebral hemorrhage (HR, 2.14 [95% CI, 1.63\u20132.81]), subarachnoid hemorrhage (HR, 1.90 [95% CI, 1.27\u20132.84), stroke\u2010related death (HR, 2.20 [95% CI, 1.73\u20132.80]), and all\u2010cause death (HR, 2.59 [95% CI, 2.46\u20132.73]). Using the aspartate aminotransferase to platelet ratio index as an alternative score, liver fibrosis was correlated with magnified risk of intracerebral hemorrhage (HR, 3.76 [95% CI, 2.38\u20135.93]) and subarachnoid hemorrhage (HR, 3.05 [95% CI, 1.51\u20136.13]) compared with ischemic stroke (HR, 1.58 [95% CI, 1.17\u20132.14]). Restricted cubic spline analysis showed nonlinear associations of the Fibrosis\u20104 index and aspartate aminotransferase to platelet ratio index with stroke incidence and all\u2010cause death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Liver fibrosis is associated with increased risk of incident stroke and death among people without previous stroke or cardiovascular events, with particularly greater risk of intracerebral hemorrhage and subarachnoid hemorrhage. Noninvasive indices of liver fibrosis may serve as an easily accessible marker to detect individuals facing elevated risk of stroke and death in the primary prevention settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.037081","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T06:21:43Z","timestamp":1737958903000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Association Between Liver Fibrosis and Risk of Incident Stroke and Mortality: A\u00a0Large Prospective Cohort Study"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7974-7075","authenticated-orcid":false,"given":"Zijie","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurology The Second Affiliated Hospital of Anhui Medical University Hefei 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