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Cirrhosis of liver may increase risk of stroke

New York: Older adults suffering from cirrhosis — the severe scarring of the liver — may be at an increased risk of stroke, especially hemorrhagic, a study has found.

Cirrhosis is a condition of chronic liver damage from a variety of causes leading to scarring and liver failure.

The findings showed that the incidence of stroke was 2.17 per cent per year in patients with cirrhosis and 1.11 per cent per year in patients without cirrhosis.

“Cirrhosis is associated with extrahepatic hemorrhagic and thrombotic processes, such as gastrointestinal bleeding and venous thromboembolism. The cerebrovascular complications of cirrhosis are comparatively less well understood,” said Neal S. Parikh, from the New York-Presbyterian Hospital, New York.

The association between cirrhosis and increased risk of stroke, may include mixed coagulopathy — impaired clotting — caused by patients’ underlying vascular risk factors that may be further heightened by cirrhosis.

In addition, the underlying causes of cirrhosis such as alcohol abuse, hepatitis C infection and metabolic diseases may also contribute to stroke risk.

“We found that patients with cirrhosis faced an increased risk of stroke after adjustment for patient demographic characteristics, traditional stroke risk factors, and relevant comorbidities,” Parikh said.

“Cirrhosis appeared to be more strongly associated with hemorrhagic stroke than ischemic stroke. Similar associations were seen regardless of cirrhosis type, although decompensated cirrhosis (or liver failure) appeared to have the strongest association with stroke,” he added.

For the study, published by JAMA Neurology, the team included more than 1.6 million Medicare beneficiaries, older than 66.

Of these, 15,586 patients (1.0 per cent) had cirrhosis and during an average of about four years of follow-up, and 77,268 patients were hospitalised with a stroke.