Serial measurement of interleukin-6 and risk of mortality in anticoagulated patients with atrial fibrillation: Insights from ARISTOTLE and RE-LY trials.

Journal of Thrombosis and Haemostasis : JTH
Julia AulinJonas Oldgren

Abstract

The inflammatory biomarker interleukin-6 (IL-6) is associated with mortality in atrial fibrillation (AF). To investigate if repeated IL-6 measurements improve the prognostication for stroke or systemic embolism, major bleeding, and mortality in anticoagulated patients with AF. IL-6 levels by ELISA were measured at study entry and at 2 months in 4830 patients in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial with 1.8 years median follow-up. In the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial, IL-6 was measured at study entry, 3, 6, and 12 months in 2559 patients with 2.0 years median follow-up. Associations between a second IL-6 measurement and outcomes, adjusted for baseline IL-6, clinical variables, and other cardiovascular biomarkers, were analyzed by Cox regression. Median IL-6 levels were 2.0 ng/L (interquartile range [IQR] 1.30-3.20) and 2.10 ng/L (IQR 1.40-3.40) at the two time-points in ARISTOTLE, and, in RE-LY, 2.5 ng/L (IQR 1.6-4.3), 2.5 ng/L (IQR 1.6-4.2), 2.4 ng/L (IQR 1.6, 3.9), and 2.4 ng/L (IQR 1.5, 3.9), respectively. IL-6 was associated with mortality; hazard ratios per 50% higher IL-6 at 2 or 3 months, respectively, were ...Continue Reading

References

Aug 1, 1991·Stroke; a Journal of Cerebral Circulation·P A WolfW B Kannel
Apr 3, 1997·The New England Journal of Medicine·P M RidkerC H Hennekens
Sep 1, 2009·The New England Journal of Medicine·Stuart J ConnollyUNKNOWN RE-LY Steering Committee and Investigators
Aug 30, 2011·The New England Journal of Medicine·Christopher B GrangerUNKNOWN ARISTOTLE Committees and Investigators
Feb 22, 2012·Food and Chemical Toxicology : an International Journal Published for the British Industrial Biological Research Association·Sandra BelijMilena Kataranovski
Feb 7, 2013·European Heart Journal·Ziad HijaziLars Wallentin

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Citations

Dec 21, 2020·European Journal of Internal Medicine·Stefano FumagalliUNKNOWN PURE-Rhythm Trial Investigators

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