ISSN 2149-2263 | E-ISSN 2149-2271
Volume : 25 Issue : 12 Year : 2021
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The Anatolian Journal of Cardiology Prognostic value of interleukin-6 in atrial fibrillation: A cohort study and meta-analysis [Anatol J Cardiol]
Anatol J Cardiol. 2021; 25(12): 872-879 | DOI: 10.5152/AnatolJCardiol.2021.69299

Prognostic value of interleukin-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-People’s Republic of China;Evidence-based Medicine and Clinical Epidemiology Center, Army Medical University (Third Military Medical University); Chongqing-People’s Republic of China
2Department of Sciences&Education, Chongqing General Hospital, University of Chinese Academy of Sciences; Chongqing-People’s Republic of China
3Department of Cardiology, Southwest Hospital, Army Medical University (Third Military Medical University); Chongqing-People’s Republic of China
4Cardiovascular Disease Center, Third Affiliated Hospital of Chongqing Medical University; Chongqing-People’s Republic of China

Objective: The prognostic value of interleukin-6 (IL-6) in patients with atrial fibrillation (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 patients with AF.
Methods: A cohort study was performed in newly diagnosed non-valvular patients with AF. A total of 217 patients with AF 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 patients with AF.
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 patients with AF. Adding IL-6 levels to CHA2DS2-VASc score showed limited improvement of the predictive power for stroke [area under curve (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 patients with AF. Adding IL-6 biomarker to the CHA2DS2-VASc score may help to determine the management of AF treatment.

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

Xiaoyue Jia, Xi Cheng, Na Wu, Ying Xiang, Long Wu, Bin Xu, Chengying Li, Zhihui Zhang, Shifei Tong, Li Zhong, Yafei Li. Prognostic value of interleukin-6 in atrial fibrillation: A cohort study and meta-analysis. Anatol J Cardiol. 2021; 25(12): 872-879

Corresponding Author: Yafei Li, China
Manuscript Language: English