Prognostic Value of Interleukin-6 for Stroke and Mortality in Atrial Fibrillation

In a study, published in the Anatolian Journal of Cardiology, researchers examined the prognostic value of interleukin-6 (IL-6) for mortality and stroke in atrial fibrillation (AFib). The investigators, led by Xiaoyue Jia, conducted a cohort trial and a meta-analysis and found that increased levels of circulating IL-6 was “significantly associated with a greater risk of stroke and all-cause mortality in patients with AFib.”

The cohort portion of the study followed 217 patients with newly diagnosed, non-valvular AFib for a mean duration of 27 months. The prognostic value of IL-6 for stroke and mortality was evaluated with the Cox regression model, and IL-6 was also added to the CHA2DS2-VASc scoring tool to calculate the incremental value. The meta-analysis portion of this study included all reported cohort studies as well as the authors’ own cohort’s data.

In their cohort, the researchers found that elevated plasma levels of IL-6 was an independent risk factor for predicting both stroke (hazard ratio [HR] = 3.81; 95% confidence interval [CI], 1.11–13.05; p = 0.033) and all-cause mortality (HR = 3.11; 95% CI, 1.25–7.72; p = 0.015) in patients with AFib. Adding IL-6 to CHA2DS2-VASc scoring demonstrated only limited improvement of the predictive power for stroke (area under the curve [AUC] from 0.81 to 0.88; p = 0.005). The follow-up meta-analysis confirmed the associations between increased circulating level of IL-6 and increased risk of stroke (HR = 1.97; 95% CI, 1.22–3.17; p = 0.006) as well as mortality (HR = 2.73; 95% CI, 2.29–3.25; p <0.001).

The authors presented their data to deepen current understanding of the prognostic value of IL-6 for stroke and mortality in patients with AFib, and they concluded that “adding IL-6 biomarker to the CHA2DS2-VASc score may help to determine the management of AF treatment.”