Prognostic value of blood interleukin-6 in the prediction of functional outcome after stroke: a systematic review and meta-analysis

Alejandro Bustamante; Tomás Sobrino; Dolors Giralt; Teresa García-Berrocoso; Victor Llombart; Iratxe Ugarriza; Marc Espadaler; Noelia Rodríguez; Cathie Sudlow; Mar Castellanos; Craig J Smith; Manuel Rodríguez-Yánez; Ulrike Waje-Andreassen; David Tanne; Jun Oto; Mark Barber; Hans Worthmann; Katja E Wartenberg; Kyra J Becker; Baidarbhi Chakraborty; Seung-Hun Oh; William N Whiteley; José Castillo; Joan Montaner

doi:10.1016/j.jneuroim.2014.07.015

Prognostic value of blood interleukin-6 in the prediction of functional outcome after stroke: a systematic review and meta-analysis

J Neuroimmunol. 2014 Sep 15;274(1-2):215-24. doi: 10.1016/j.jneuroim.2014.07.015. Epub 2014 Jul 24.

Authors

Alejandro Bustamante¹, Tomás Sobrino², Dolors Giralt³, Teresa García-Berrocoso³, Victor Llombart³, Iratxe Ugarriza⁴, Marc Espadaler³, Noelia Rodríguez⁵, Cathie Sudlow⁶, Mar Castellanos⁷, Craig J Smith⁸, Manuel Rodríguez-Yánez², Ulrike Waje-Andreassen⁹, David Tanne¹⁰, Jun Oto¹¹, Mark Barber¹², Hans Worthmann¹³, Katja E Wartenberg¹⁴, Kyra J Becker¹⁵, Baidarbhi Chakraborty¹⁶, Seung-Hun Oh¹⁷, William N Whiteley⁶, José Castillo², Joan Montaner¹⁸

Affiliations

¹ Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain; Neurology Department, Hospital Vall d'Hebron, Barcelona, Spain.
² Department of Neurology, Clinical Neurosciences Research Laboratory, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, Santiago de Compostela, Spain.
³ Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain.
⁴ Neurology Department, Hospital de Cruces, Bilbao, Spain.
⁵ Neurology Department, Hospital Vall d'Hebron, Barcelona, Spain.
⁶ Centre for Clinical Brain Sciences, University of Edinburgh, UK.
⁷ Department of Neurology, Hospital Universitario Dr. Josep Trueta of Girona, Biomedical Research Institute of Girona, Spain.
⁸ Stroke and Vascular Research Centre, University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, UK.
⁹ Department of Neurology, Haukeland University Hospital, Norway.
¹⁰ Sagol Neuroscience Center, Chaim Sheba Medical Center and Tel Aviv University, Israel.
¹¹ University of Tokushima Graduate School, Japan.
¹² Stroke Managed Clinical Network, NHS Lanarkshire, UK.
¹³ Department of Neurology, Hannover Medical School, Hannover, Germany.
¹⁴ Department of Neurology, Martin-Luther-University Halle-Wittenberg, Germany.
¹⁵ Department of Neurology and Neurological Surgery, University of Washington School of Medicine, Seattle, WA, United States.
¹⁶ Department of Biochemistry, Dr. D. Y. Patil Medical College, Mumbai, India.
¹⁷ Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
¹⁸ Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Universitat Autònoma de Barcelona, Spain; Neurology Department, Hospital Vall d'Hebron, Barcelona, Spain. Electronic address: [email protected].

PMID: 25091431
DOI: 10.1016/j.jneuroim.2014.07.015

Abstract

We aimed to quantify the association of blood interleukin-6 (IL-6) concentrations with poor outcome after stroke and its added predictive value over clinical information. Meta-analysis of 24 studies confirmed this association with a weighted mean difference of 3.443 (1.592-5.294) pg/mL, despite high heterogeneity and publication bias. Individual participant data including 4112 stroke patients showed standardized IL-6 levels in the 4th quartile were independently associated with poor outcome (OR=2.346 (1.814-3.033), p<0.0001). However, the additional predictive value of IL-6 was moderate (IDI=1.5%, NRI=5.35%). Overall these results indicate an unlikely translation of IL-6 into clinical practice for this purpose.

Keywords: Individual participant data analysis; Interleukin-6; Meta-analysis; Outcome; Post-stroke infection; Stroke.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Biomarkers / blood
Humans
Interleukin-6 / blood
Interleukin-6 / immunology*
Predictive Value of Tests
Prognosis
Recovery of Function / immunology*
Stroke / diagnosis
Stroke / immunology*
Stroke / metabolism

Substances

Biomarkers
IL6 protein, human
Interleukin-6

Abstract

Publication types

MeSH terms

Substances

Grants and funding