ISSN 2149-2263 | E-ISSN 2149-2271
Volume : Issue : Year : 2021
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The Anatolian Journal of Cardiology Prognostic value of IL-6 in atrial fibrillation: A cohort study and meta-analysis [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-69299

Prognostic value of IL-6 in atrial fibrillation: A cohort study and meta-analysis

Xiaoyue Jia1, Xi Cheng2, Na Wu1, Ying Xiang1, Long Wu1, Bin Xu1, Chengying Li1, Zhihui Zhang3, Shifei Tong4, Li Zhong4, Yafei Li1
1Department of Epidemiology, College of Preventive Medicine, Army medical University (Third Military Medical University), Chongqing 400038, People’s Republic of China.
2Department of Sciences & Education, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400013, People‘s Republic of China.
3Department of Cardiology, Southwest Hospital, Army medical University (Third Military Medical University), Chongqing 400038, People’s Republic of China.
4Cardiovascular Disease Center, Third Affiliated Hospital of Chongqing Medical University, Chongqing 401120, People’s Republic of China.

Objective: The prognostic value of IL-6 in patients with AF has not been fully elucidated. Therefore we conducted a cohort study and a meta-analysis to assess the predictive value of IL-6 for stroke and mortality in AF patients. Methods: A cohort study was performed in newly diagnosed non-valvular AF patients. A total of 217 AF patients were followed up for a mean of 27 months. A multivariate Cox regression analysis was used to evaluate the association between IL-6 and stroke/all-cause mortality. The incremental value was also assessed by adding IL-6 to the CHA2DS2-VASc score. Besides, a meta-analysis of all reported cohort studies and our cohort study was conducted to validate the association of circulating IL-6 and stroke/mortality in AF patients. Results: Our cohort study showed that elevated plasma level of IL-6 was an independent risk factor for predicting 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 AF patients. Adding IL-6 levels to CHADS-VASC score showed limited improvement of the predictive power for stroke (AUC from 0.81 to 0.88, P = 0.006). Meta-analysis confirmed that increased circulating level of IL-6 was significantly associated with increased risk of stroke (pooled HR=1.97; 95% CI, 1.22-3.17; P=0.006) and all-cause mortality (pooled HR=2.73; 95% CI, 2.29-3.25; P<0.001). Conclusion: Increased circulating level of IL-6 was significantly associated with greater risk of stroke and all-cause mortality in AF patients. Adding IL-6 biomarker to the CHA2DS2-VASc score may help to determine the management of AF treatment.

Keywords: Artrial fibrillation, prognosis, interleukin-6, meta-analysis, stroke, mortality



Corresponding Author: Yafei Li, China