C-Reactive Protein, Interleukin-6, and Vascular Recurrence After Stroke: An Individual Participant Data Meta-Analysis.

Humans Interleukin-6 C-Reactive Protein / analysis Ischemic Attack, Transient / prevention & control Prospective Studies Stroke / prevention & control Ischemic Stroke Recurrence
coronary artery disease infarction inflammation ischemic stroke thrombosis

Journal

Stroke
ISSN: 1524-4628
Titre abrégé: Stroke
Pays: United States
ID NLM: 0235266

Informations de publication

Date de publication:
05 2023
Historique:
medline: 26 4 2023
pubmed: 8 4 2023
entrez: 7 4 2023
Statut: ppublish

Résumé

Anti-inflammatory therapies reduce recurrent vascular events in coronary disease. Existing studies have reported highly conflicting findings for the association of blood inflammatory markers with vascular recurrence after stroke leading to uncertainty about the potential of anti-inflammatory therapies after stroke and no consensus about the utility of measurement of inflammatory markers in current guidelines. We investigated the association between hsCRP (high-sensitivity C-reactive protein), IL-6 (interluekin-6), and recurrent major adverse cardiovascular events (MACE), and stroke from individual participant data from 8420 patients with ischemic stroke/transient ischemic attack from 10 prospective studies. We did within-study multivariable regression analyses and then combined adjusted risk ratio (RR) by random-effects meta-analysis. During 18 920 person-years of follow-up, 1407 (16.7% [95% CI, 15.9-17.5]) patients had MACE and 1191 (14.1% [95% CI, 13.4-14.9]) patients had recurrent stroke. On bivariate analysis, baseline IL-6 was associated with MACE (RR, 1.26 [95% CI, 1.10-1.43]) and recurrent stroke (RR, 1.18 [95% CI, 1.05-1.32]), per unit increase log Blood markers of inflammation were independently associated with vascular recurrence after stroke, strengthening the rationale for randomized trials of anti-inflammatory therapies for secondary prevention after ischemic stroke/TIA.

Sections du résumé

BACKGROUND
Anti-inflammatory therapies reduce recurrent vascular events in coronary disease. Existing studies have reported highly conflicting findings for the association of blood inflammatory markers with vascular recurrence after stroke leading to uncertainty about the potential of anti-inflammatory therapies after stroke and no consensus about the utility of measurement of inflammatory markers in current guidelines.
METHODS
We investigated the association between hsCRP (high-sensitivity C-reactive protein), IL-6 (interluekin-6), and recurrent major adverse cardiovascular events (MACE), and stroke from individual participant data from 8420 patients with ischemic stroke/transient ischemic attack from 10 prospective studies. We did within-study multivariable regression analyses and then combined adjusted risk ratio (RR) by random-effects meta-analysis.
RESULTS
During 18 920 person-years of follow-up, 1407 (16.7% [95% CI, 15.9-17.5]) patients had MACE and 1191 (14.1% [95% CI, 13.4-14.9]) patients had recurrent stroke. On bivariate analysis, baseline IL-6 was associated with MACE (RR, 1.26 [95% CI, 1.10-1.43]) and recurrent stroke (RR, 1.18 [95% CI, 1.05-1.32]), per unit increase log
CONCLUSIONS
Blood markers of inflammation were independently associated with vascular recurrence after stroke, strengthening the rationale for randomized trials of anti-inflammatory therapies for secondary prevention after ischemic stroke/TIA.

Identifiants

DOI: 10.1161/STROKEAHA.122.040529 PMID: 37026458
pubmed: 37026458
doi: 10.1161/STROKEAHA.122.040529
doi:

Substances chimiques

Interleukin-6 0
C-Reactive Protein 9007-41-4

Types de publication

Meta-Analysis Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1289-1299

Commentaires et corrections

Type : CommentIn

Auteurs

John J McCabe (JJ)

Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland (J.J.M., C.W., S.G., P.J.K.).
School of Medicine, University College Dublin (UCD), Ireland (J.J.M., S.G., P.J.K.).
Department of Geriatric Medicine (J.J.M., S.G.), Mater Misericordiae University Hospital, Dublin, Ireland.
ORCID: 0000-0003-2029-1303

Cathal Walsh (C)

Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland (J.J.M., C.W., S.G., P.J.K.).
Health Research Institute and Mathematics Applications Consortium for Science and Industry (MACSI), Department of Mathematics and Statistics, University of Limerick, Ireland (C.W.).
ORCID: 0000-0001-6599-9562

Sarah Gorey (S)

Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland (J.J.M., C.W., S.G., P.J.K.).
School of Medicine, University College Dublin (UCD), Ireland (J.J.M., S.G., P.J.K.).
Department of Geriatric Medicine (J.J.M., S.G.), Mater Misericordiae University Hospital, Dublin, Ireland.
ORCID: 0000-0001-8079-7969

Katie Harris (K)

George Institute for Global Health, University of New South Wales, Sydney, Australia (K.H., M.W.).
ORCID: 0000-0003-2444-2869

Pablo Hervella (P)

Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neuroscience Research Laboratory, Health Research Institute of Santiago de Compostela, Spain (P.H., R.I.-R.).

Ramon Iglesias-Rey (R)

Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neuroscience Research Laboratory, Health Research Institute of Santiago de Compostela, Spain (P.H., R.I.-R.).

Christina Jern (C)

Department of Laboratory Medicine, Institute of Biomedicine, the Sahlgrenska Academy, University of Gothenburg, Sweden (C.J., A.P.).
Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden (C.J., A.P.).
ORCID: 0000-0002-7531-2354

Linxin Li (L)

Wolfson Centre for the Prevention of Stroke and Dementia (L.L., P.M.R.), University of Oxford, United Kingdom.
ORCID: 0000-0002-3636-8355

Nobukazu Miyamoto (N)

Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan (N.M., Y.U.).

Joan Montaner (J)

Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Spain (J.M.).
Institute de Biomedicine of Seville, IBiS/Hospital Universitario Virgen del Rocío/CSIC/University of Seville, Neurology, Spain (J.M.).
Virgen Macarena Hospital, Neurology, Sevilla, Spain (J.M.).
Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain (J.M.).
ORCID: 0000-0003-4845-2279

Annie Pedersen (A)

Department of Laboratory Medicine, Institute of Biomedicine, the Sahlgrenska Academy, University of Gothenburg, Sweden (C.J., A.P.).
Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden (C.J., A.P.).

Francisco Purroy (F)

Department of Neurology, Hospital Universitari Arnau de Vilanova, Lleida, Spain (F.P., M.V.-P.).
Department of Clinical Neurosciences, Institut Reserca Biomèdica Lleida, University of Lleida, Spain (F.P., M.V.-P.).
ORCID: 0000-0002-1808-5968

Peter M Rothwell (PM)

Wolfson Centre for the Prevention of Stroke and Dementia (L.L., P.M.R.), University of Oxford, United Kingdom.
ORCID: 0000-0001-9739-9211

Catherine Sudlow (C)

Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics (C.S.), University of Edinburgh, United Kingdom.
Centre for Clinical Brain Sciences (C.S., W.W.), University of Edinburgh, United Kingdom.
ORCID: 0000-0002-7725-7520

Yuji Ueno (Y)

Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan (N.M., Y.U.).
ORCID: 0000-0002-8617-3695

Mikel Vicente-Pascual (M)

Department of Neurology, Hospital Universitari Arnau de Vilanova, Lleida, Spain (F.P., M.V.-P.).
Department of Clinical Neurosciences, Institut Reserca Biomèdica Lleida, University of Lleida, Spain (F.P., M.V.-P.).
ORCID: 0000-0002-5445-7853

William Whiteley (W)

Nuffield Department of Population Health (W.W.), University of Oxford, United Kingdom.
Centre for Clinical Brain Sciences (C.S., W.W.), University of Edinburgh, United Kingdom.
ORCID: 0000-0002-4816-8991

Mark Woodward (M)

George Institute for Global Health, University of New South Wales, Sydney, Australia (K.H., M.W.).
George Institute for Global Health, Imperial College London, United Kingdom (M.W.).
ORCID: 0000-0001-9800-5296

Peter J Kelly (PJ)

Health Research Board (HRB) Stroke Clinical Trials Network Ireland (SCTNI), Dublin, Ireland (J.J.M., C.W., S.G., P.J.K.).
School of Medicine, University College Dublin (UCD), Ireland (J.J.M., S.G., P.J.K.).
Department of Neurology (P.J.K.), Mater Misericordiae University Hospital, Dublin, Ireland.
ORCID: 0000-0003-4772-6565

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questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › C-Reactive Protein, Interleukin-6, and...
questionsmedicales.fr › Facteurs biologiques › Protéines et peptides de signalisation intercellulaire › Cytokines › Interleukines › Interleukine-6 › C-Reactive Protein, Interleukin-6, and...
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questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Encéphalopathie ischémique › Accident ischémique transitoire › C-Reactive Protein, Interleukin-6, and...
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questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › C-Reactive Protein, Interleukin-6, and...
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