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Original research
A lower admission level of interleukin-6 is associated with first-pass effect in ischemic stroke patients
  1. Laura Mechtouff1,2,
  2. Thomas Bochaton2,3,
  3. Alexandre Paccalet2,
  4. Claire Crola Da Silva2,
  5. Marielle Buisson4,
  6. Camille Amaz4,
  7. Laurent Derex1,
  8. Elodie Ong1,2,
  9. Yves Berthezene5,6,
  10. Nathalie Dufay7,
  11. Michel Ovize2,4,
  12. Nathan Mewton2,4,
  13. Tae-Hee Cho1,2,
  14. Norbert Nighoghossian1,2,
  15. Omer F Eker5
  1. 1Stroke Department, Hospices Civils de Lyon, Lyon, France
  2. 2CarMeN Laboratory, INSERM U1060, University Lyon 1, Lyon, France
  3. 3Cardiac Intensive Care Unit, Hospices Civils de Lyon, Lyon, France
  4. 4Clinical Investigation Center, INSERM 1407, Hospices Civils de Lyon, Lyon, France
  5. 5Neuroradiology Department, Hospices Civils de Lyon, Lyon, France
  6. 6CREATIS, CNRS UMR 5220, INSERM U1044, University Lyon 1, Lyon, France
  7. 7NeuroBioTec, CRB, Hospices Civils de Lyon, Lyon, France
  1. Correspondence to Dr Laura Mechtouff, Stroke Department, Hospices Civils de Lyon, Lyon 69002, France; laura.mechtouff{at}chu-lyon.fr

Abstract

Background First-pass effect (FPE) defined as a complete or near-complete reperfusion achieved after a single thrombectomy pass is predictive of favorable outcome in acute ischemic stroke (AIS) patients. We aimed to assess whether admission levels of inflammatory markers are associated with FPE.

Methods HIBISCUS-STROKE (CoHort of Patients to Identify Biological and Imaging markerS of CardiovascUlar Outcomes in Stroke) includes AIS patients with large vessel occlusion treated with mechanical thrombectomy following brain MRI. C-reactive protein, interleukin (IL)-6, IL-8, IL-10, monocyte chemoattractant protein-1, soluble tumor necrosis factor receptor I, soluble form suppression of tumorigenicity 2, matrix metalloproteinase-9 (MMP-9), soluble P-selectin, and vascular cellular adhesion molecule-1 were measured in admission sera using an ELISA assay. FPE was defined as a complete or near-complete reperfusion (thrombolysis in cerebral infarction scale (TICI) 2c or 3) after the first pass. A multivariate logistic regression analysis was performed to assess independent factors associated with FPE.

Results A total of 151 patients were included. Among them, 43 (28.5%) patients had FPE. FPE was associated with low admission levels of IL-6, MMP-9, and platelet count, an older age, lack of hypertension, lack of tandem occlusion, a shorter thrombus length, and a reduced procedural time. Following multivariate analysis, a low admission level of IL-6 was associated with FPE (OR 0.66, 95% CI 0.46 to 0.94). Optimal cut-off of IL-6 level for distinguishing FPE from non-FPE was 3.0 pg/mL (sensitivity 92.3%, specificity 42.3%).

Conclusion A lower admission level of IL-6 is associated with FPE.

  • stroke
  • thrombectomy
  • inflammatory response

Data availability statement

Data are available upon reasonable request. Further anonymized data can be made available to qualified investigators on request to the corresponding author.

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Data availability statement

Data are available upon reasonable request. Further anonymized data can be made available to qualified investigators on request to the corresponding author.

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Footnotes

  • Twitter @BochatonThomas, @alexPaccalet

  • NN and OFE contributed equally.

  • Contributors Study design: LM, MO, NN, OFE. Acquisition, analysis, or interpretation of data: all authors. Drafting the manuscript: LM, NN, OFE. Revising the manuscript critically for important intellectual content: TB, AP, CCDS, MB, CA, LD, EO, YB, ND, MO, NM, T-HC. Statistical analysis: LM, CA. Supervision: NN, OFE. Final approval of the version and agreement to be accountable for all aspects of the work: all authors.

  • Funding This work was supported by the RHU MARVELOUS (ANR-16-RHUS-0009) of Université Claude Bernard Lyon-1 (UCBL), within the program “Investissements d'Avenir” operated by the French National Research Agency (ANR) and the CASDEN prize from CASDEN/Fondation de l’Avenir awarded to Laura Mechtouff.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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