Title:Association between Interleukin-6 and Multiple Acute Infarctions in Symptomatic Intracranial Atherosclerotic Disease
Volume: 21
Issue: 3
Author(s): Jinglin Mo, Zimo Chen, Mengxing Wang, Aichun Cheng, Jiejie Li, Yuesong Pan, Yong Jiang, Jing Jing, Yongjun Wang, Yuehua Pu*Zixiao Li*
Affiliation:
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100071, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100071, China
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100071, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100071, China
- National Center for Healthcare Quality Management in Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100071, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100071, China
- Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, 100071, China
- Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China
Keywords:
Interleukin-6, symptomatic intracranial atherosclerotic disease, ischemic stroke, multiple acute infarctions, inflammation, atherosclerosis.
Abstract:
Background: Interleukin-6 (IL-6) plays an important role in the pathophysiology
of atherosclerosis. This study aimed to determine whether IL-6 is a crucial biomarker associated
with Multiple Acute Infarctions (MAIs), which indicate an important stroke mechanism of
artery-to-artery embolism with a high risk of stroke recurrence in symptomatic Intracranial
Atherosclerotic Disease (sICAD). We tested the association between circulating IL-6 levels and
the presence of MAIs in a prospective population-based registry.
Methods: We included 1,919 patients with sICAD and baseline IL-6 levels from the Third China
National Stroke Registry for the current analysis, The baseline IL-6 was centrally measured at Beijing
Tiantan Hospital, Images of the brain parenchyma and vascular structures were digitized and
then blindly and independently read by two groups of trained readers, The recruited patients were
divided into 3 groups according to IL-6 tertiles, The relationship between baseline IL-6 tertile levels
and the presence of MAIs was modeled using multivariate logistic regression.
Results: Compared to patients in the first IL-6 tertile those in the second and third tertiles demonstrated
a significantly higher proportion of MAIs. The odds ratios were 1.81 [95% Confidence Interval
(CI), 1.42-2.30] for the second versus first tertile and 2.15 (95% CI 1.66-2.79) for the third versus
first tertile, The proportion of patients with MAIs increased with rising IL-6 tertiles observed
at 59.3%, 71.6% and 76.4% for the first, second and third tertiles, respectively (P for trend <
0.001). The association between higher IL-6 tertiles and increased proportion of MAIs was also
present in subgroups defined by age < 65 years, age ≥ 65 years, male, and high-sensitivity C-reactive
Protein (hs-CRP) ≥ 2 mg/L. Furthermore, a significant interaction was detected for the hs-
CRP subgroup (P = 0.038). In sensitivity analyses, the positive correlation between IL-6 levels
and the proportion of MAIs remained consistent.
Conclusion: In patients with sICAD, higher IL-6 levels were associated with an increased proportion
of MAIs. IL-6 could be used as a biomarker and a potential therapeutic target for future
atherosclerosis treatment and prevention in patients with sICAD.
