Associations of Rheumatoid Factor, Rheumatoid Arthritis, and Interleukin-6 Inhibitor with the Prognosis of Ischemic Stroke: a Prospective Multicenter Cohort Study and Mendelian Randomization Analysis.

Publisher: Springer Country of Publication: United States NLM ID: 101517297 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1868-601X (Electronic) Linking ISSN: 18684483 NLM ISO Abbreviation: Transl Stroke Res Subsets: MEDLINE

Original Publication: New York : Springer

Mendelian Randomization Analysis* ; Interleukin-6*/blood ; Interleukin-6*/genetics ; Ischemic Stroke*/genetics ; Ischemic Stroke*/blood ; Arthritis, Rheumatoid*/genetics ; Arthritis, Rheumatoid*/blood ; Arthritis, Rheumatoid*/complications ; Arthritis, Rheumatoid*/drug therapy ; Rheumatoid Factor*/blood; Humans ; Male ; Female ; Middle Aged ; Aged ; Prognosis ; Prospective Studies ; Cohort Studies ; China/epidemiology

Rheumatoid factor (RF), an established diagnostic biomarker for rheumatoid arthritis (RA), is associated with cardiovascular diseases, but its impact on clinical outcomes of ischemic stroke remains unclear. We aimed to investigate the observational associations between serum RF and prognosis of ischemic stroke, and further examined the genetic associations of RA and its therapeutic strategy, interleukin-6 (IL-6) inhibitor, with prognosis of ischemic stroke. We measured serum RF levels in 3474 Chinese ischemic stroke patients from the China Antihypertensive Trial in Acute Ischemic Stroke. The primary outcome was the composite outcome of death or major disability (modified Rankin Scale score ≥3) at 3 months after stroke onset. Mendelian randomization (MR) analyses were performed to examine the associations of genetically predicted RA and IL-6 inhibition with prognosis of ischemic stroke. During 3 months of follow-up, 866 patients (25.43%) experienced death or major disability. After multivariate adjustment, RF-positive was significantly associated with a high risk of primary outcome (OR, 1.47; 95% CI, 1.08-2.00; P =0.016) compared with RF-negative. The two-sample MR analyses suggested that genetically predicted RA was associated with an increased risk of primary outcome (OR, 1.09; 95% CI, 1.01-1.18; P=0.021), while genetically predicted IL-6 inhibition was associated with a decreased risk of primary outcome (OR, 0.88; 95% CI, 0.77-0.99; P=0.041). We found that positive RF was associated with increased risks of adverse outcomes after atherosclerotic ischemic stroke, and genetically predicted RA and IL-6 inhibition increased and decreased the risks of adverse outcomes after ischemic stroke, respectively.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

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Keywords: Interleukin-6 inhibitor; Ischemic stroke; Prognosis; Rheumatoid arthritis; Rheumatoid factor

0 (Interleukin-6)
9009-79-4 (Rheumatoid Factor)
0 (IL6 protein, human)

Date Created: 20230531 Date Completed: 20240705 Latest Revision: 20240705

20240705

10.1007/s12975-023-01161-5

37256492