Frontiers in immunology · 2026
Serum IL-6 and functional outcome after endovascular therapy: the mediating role of infarct volume growth in acute ischemic stroke.
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Li Shuo, Zhang Shiyao, Ji Lifan, Qu Yanfang, Huang Zhihui, Gao Jie, Zhang Yiting, Li Zhenzhen, Sun Huiling, Zhu Lin, Jiang Teng, Yu Yadong, Deng Qiwen
Аннотация
BACKGROUND AND PURPOSE: Inflammatory factors are pivotal in systemic and central nervous system inflammation post-stroke. This study examined if peripheral inflammatory factors were associated with outcomes after endovascular therapy for acute large vessel occlusion stroke by mediating infarct growth.
METHODS: We conducted a retrospective analysis of the EVTRNA (Circulating Non-coding RNA in Acute Ischemic Stroke with Endovascular Treatment) trial. Patients who underwent pre-endovascular therapy multimodal MRI, postoperative day 1 inflammatory factor testing, and postoperative day 7 head CT for infarct volume evaluation were included in this study. Unfavorable outcome was defined as a modified Rankin Scale score of 3-5 at the 90-day follow-up. Regression analysis and mediation analysis were employed to assess the association between inflammatory factors and clinical outcomes.
RESULTS: A total of 105 patients were included in this study, of whom 51 experienced unfavorable outcomes. Univariate analysis demonstrated that elevated interleukin-6 (IL-6) levels, higher baseline National Institutes of Health Stroke Scale scores at admission, increased fasting blood glucose levels, and infarct growth were all significantly associated with unfavorable outcomes. After adjustment by multivariate analysis, IL-6 (odds ratio 1.02, 95% confidence interval 1.01-1.03) and the other aforementioned factors remained independently associated with unfavorable outcomes. Further mediation analysis revealed that infarct volume growth partially accounts for the unfavorable prognosis observed in patients with elevated IL-6 levels.
CONCLUSIONS: IL-6 was associated with unfavorable outcomes in patients undergoing endovascular therapy. Postoperative infarct volume growth partially mediated the effect of IL-6 on clinical outcomes.
METHODS: We conducted a retrospective analysis of the EVTRNA (Circulating Non-coding RNA in Acute Ischemic Stroke with Endovascular Treatment) trial. Patients who underwent pre-endovascular therapy multimodal MRI, postoperative day 1 inflammatory factor testing, and postoperative day 7 head CT for infarct volume evaluation were included in this study. Unfavorable outcome was defined as a modified Rankin Scale score of 3-5 at the 90-day follow-up. Regression analysis and mediation analysis were employed to assess the association between inflammatory factors and clinical outcomes.
RESULTS: A total of 105 patients were included in this study, of whom 51 experienced unfavorable outcomes. Univariate analysis demonstrated that elevated interleukin-6 (IL-6) levels, higher baseline National Institutes of Health Stroke Scale scores at admission, increased fasting blood glucose levels, and infarct growth were all significantly associated with unfavorable outcomes. After adjustment by multivariate analysis, IL-6 (odds ratio 1.02, 95% confidence interval 1.01-1.03) and the other aforementioned factors remained independently associated with unfavorable outcomes. Further mediation analysis revealed that infarct volume growth partially accounts for the unfavorable prognosis observed in patients with elevated IL-6 levels.
CONCLUSIONS: IL-6 was associated with unfavorable outcomes in patients undergoing endovascular therapy. Postoperative infarct volume growth partially mediated the effect of IL-6 on clinical outcomes.