Effect of il-6 and hscrp serum levels on functional prognosis in stroke patients undergoing iv-thrombolysis: Retrospective analysis

Abstract

Purpose: We evaluated the relationship between pretreatment IL-6 and hsCRP levels, symptom severity and functional outcome of patients with acute ischemic stroke (AIS) treated with IV-thrombolysis. Patients and Methods: IL-6 and hsCRP samples were obtained from 83 consecutively treated Caucasian patients with AIS prior to initiation of IV-thrombolysis. Severity of stroke symptoms was assessed using the National Institutes of Health Stroke Scale (NIHSS), whereas functional outcome was assessed with modified Rankin Scale (mRS). The commer-cially available sets of enzymatic immune tests were used to estimate the concentrations of inflammatory markers in serum. Results: Medians of IL-6 serum concentrations prior to IV-thrombolysis were lower in patients with favorable (mRS 0–2 pts) functional outcome than in those with unfavorable (mRS 3–6 pts) functional outcome, both at hospital dismission (5.92: 2.30–7.71 vs 9.46: 3.79–17.29 pg/mL; p<0.01) and on the ninetieth day from stroke onset (5.87: 2.30–10.58 vs 10.9: 5.94–17.28 pg/mL; p<0.01). There were no existing differences regarding hsCRP levels between groups (2.49: 0.11–9.82 vs 4.44: 0.32–9.87 mg/dL; p=0.30 and 2.57: 0.11–2.57 vs 2.83: 0.32–9.32 mg/dL; p=0.75, respectively). Patients with lacunar strokes were character-ized by lower median of IL-6 (5.96: 2.87–13.0% vs 7.29: 2.30–17.28; p=<0.02) and hsCRP (2.25: 0.11–9.82 vs 4.84: 0.35–9.87; p=0.01) than those with nonlacunar infarctions. Multivariate analysis showed an impact of IL-6 on mRS measured on hospital dismission and after three months, regardless of their initial NIHSS, presence of hemorrhagic transformation and type 2 diabetes. No impact of hsCRP, lacunar etiology and patients’ age on functional outcome existed. Conclusion: Regardless of the stroke etiology, pretreatment of IL-6, but not of hsCRP levels, may help to predict functional outcome after IV-thrombolysis independently of symptom severity and stroke complications.