Association of Interleukin-6 Levels and Futile Reperfusion After Mechanical Thrombectomy.

Abstract

OBJECTIVE:

To assess whether interleukin-6 (IL-6) level is a marker of futile reperfusion in patients with acute ischemic stroke (AIS) with large vessel occlusion treated with mechanical thrombectomy (MT).

METHODS:

The Cohort of Patients to Identify Biological and Imaging Markers of Cardiovascular Outcomes in Stroke (HIBISCUS-STROKE) includes patients with AIS treated with MT after MRI. We performed a sequential assessment of IL-6 (admission, 6 hours, 24 hours, 48 hours and 3 months from admission). Among patients with successful reperfusion (Thrombolysis in Cerebral Infarction scale 2b/3), reperfusion was considered effective if 3-month modified Rankin Scale (mRS) score was 0 to 2 and futile if 3-month mRS score was 3 to 6. Our model was adjusted for the main confounding variables.

RESULTS:

One hundred sixty-four patients represent the study population. One hundred thirty-three patients had successful reperfusion (81.1%), while in 46 (34.6%), reperfusion was classified as futile. In single-variable analyses, high IL-6 levels at 6, 24, and 48 hours in combination with a higher age, a prestroke mRS score >2, a history of hypertension or diabetes, lack of current smoking, a higher baseline NIH Stroke Scale score, the absence of associated intravenous thrombolysis, an intracranial internal carotid artery or a tandem occlusion, and an increased infarct growth were associated with futile reperfusion. After multivariable analyses, a high IL-6 level at 24 hours (odds ratio 6.15, 95% confidence interval 1.71-22.10) remained associated with futile reperfusion.

CONCLUSIONS:

IL-6 is a marker of futile reperfusion in the setting of MT.

• Authors: Laura Mechtouff, Thomas Bochaton, Alexandre Paccalet, Claire Crola Da Silva, Marielle Buisson, Camille Amaz, Laurent Derex, Elodie Ong, Yves Berthezene, Omer Faruk Eker, Nathalie Dufay, Nathan Mewton, Michel Ovize, Tae-Hee Cho, Norbert Nighoghossian
• Journal: Neurology (Neurology) Vol. 96 Issue 5 Pg. e752-e757 (02 02 2021) ISSN: 1526-632X [Electronic] United States
• PMID: 33262232 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2020 American Academy of Neurology.

Chemical References

• Interleukin-6

Topics

• Aged
• Aged, 80 and over
• Endovascular Procedures
• Female
• Humans
• Interleukin-6 (blood)
• Ischemic Stroke (blood, surgery)
• Male
• Medical Futility
• Middle Aged
• Multivariate Analysis
• Odds Ratio
• Prognosis
• Thrombectomy
• Treatment Failure
• Treatment Outcome