Cirrhosis tied to higher stroke risk

Takeaway

• Cirrhosis was associated with a 24% higher risk for total stroke.
• Cirrhosis was associated with a higher risk for haemorrhagic stroke but not ischaemic stroke.

Why this matters

• Study suggests careful monitoring of patients with cirrhosis; these patients should undergo imaging examination in addition to liver function tests and liver related imaging examinations.
• Prospective studies are warranted to understand the effect of nonalcoholic fatty liver disease and related cirrhosis on the risk for stroke.

Study design

• Meta-analysis of 9 observational studies, including 3,855,226 participants, evaluated association between cirrhosis and risk for stroke.
• Studies were identified after a search on PubMed, EMBASE and Web of Science until 2017.
• Funding: International Science and Technology Cooperation Project; The Capital Special Research Project.

Key results

• 187,992 patients reported stroke:
  • Total stroke, 100,442;
  • Ischaemic stroke, 26,199 and
  • Haemorrhagic stroke, 61,281.
• Risk for total stroke was significantly higher in patients with cirrhosis vs those without (relative risk [RR], 1.24; 95% CI, 1.01-1.48).
• Risk for haemorrhagic stroke was 35% higher in patients with cirrhosis vs those without (RR, 1.35; 95% CI, 1.06-1.64).
• Cirrhosis was not associated with the risk for ischaemic stroke (RR, 0.90; 95% CI, 0.41-1.38).

Limitations

• All included studies were observational in design.
• Heterogeneity among the included studies.