Associations of proinflammatory cytokines with the risk of recurrent stroke.
BACKGROUND AND PURPOSE: There are few reports on proinflammatory cytokines and risk of primary or recurrent stroke. We studied the association of interleukin (IL)-6, IL-18, and tumor necrosis factor-alpha (TNF-alpha) with recurrent stroke in a nested case-control study derived from the Perindopril...
| Main Authors: | , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
2008
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| _version_ | 1797090963101843456 |
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| author | Welsh, P Lowe, G Chalmers, J Campbell, D Rumley, A Neal, B MacMahon, S Woodward, M |
| author_facet | Welsh, P Lowe, G Chalmers, J Campbell, D Rumley, A Neal, B MacMahon, S Woodward, M |
| author_sort | Welsh, P |
| collection | OXFORD |
| description | BACKGROUND AND PURPOSE: There are few reports on proinflammatory cytokines and risk of primary or recurrent stroke. We studied the association of interleukin (IL)-6, IL-18, and tumor necrosis factor-alpha (TNF-alpha) with recurrent stroke in a nested case-control study derived from the Perindopril Protection Against Recurrent Stroke Study (PROGRESS). METHODS: We performed a nested case-control study of 591 strokes (472 ischemic, 83 hemorrhagic, 36 unknown subtype) occurring during a randomized, placebo-controlled multicenter trial of perindopril-based therapy in 6105 patients with a history of stroke or transient ischemic attack. Controls were matched for age, treatment group, sex, region, and most recent qualifying event at entry to the parent trial. RESULTS: IL-6 and TNF-alpha, but not IL-18, were associated with risk of recurrent ischemic stroke independently of conventional risk markers. Adjusted odds ratios comparing the highest to lowest third of their distributions were 1.33 (95% CI, 1.00 to 1.78) for IL-6 and 1.46 (1.02 to 2.10) for TNF-alpha. No inflammatory marker was associated with hemorrhagic stroke risk. In multivariable models, IL-6 and TNF-alpha fully explained observed associations of C-reactive protein and fibrinogen with risk of ischemic stroke, but TNF-alpha retained borderline significance after full adjustment. CONCLUSIONS: Inflammatory markers associated with the acute-phase response (IL-6, TNF-alpha, C-reactive protein, and fibrinogen, but not IL-18) are associated with risk of recurrent stroke. These markers are dependent on each other in multivariable models, and once all were included, only TNF-alpha retained a borderline association. Markers of generalized inflammation of the acute-phase response are associated with recurrent stroke, rather than IL-6, C-reactive protein, or fibrinogen in particular. |
| first_indexed | 2024-03-07T03:26:13Z |
| format | Journal article |
| id | oxford-uuid:b91e7952-1034-48b6-a4c4-46c792806eaf |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T03:26:13Z |
| publishDate | 2008 |
| record_format | dspace |
| spelling | oxford-uuid:b91e7952-1034-48b6-a4c4-46c792806eaf2022-03-27T05:00:49ZAssociations of proinflammatory cytokines with the risk of recurrent stroke.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b91e7952-1034-48b6-a4c4-46c792806eafEnglishSymplectic Elements at Oxford2008Welsh, PLowe, GChalmers, JCampbell, DRumley, ANeal, BMacMahon, SWoodward, M BACKGROUND AND PURPOSE: There are few reports on proinflammatory cytokines and risk of primary or recurrent stroke. We studied the association of interleukin (IL)-6, IL-18, and tumor necrosis factor-alpha (TNF-alpha) with recurrent stroke in a nested case-control study derived from the Perindopril Protection Against Recurrent Stroke Study (PROGRESS). METHODS: We performed a nested case-control study of 591 strokes (472 ischemic, 83 hemorrhagic, 36 unknown subtype) occurring during a randomized, placebo-controlled multicenter trial of perindopril-based therapy in 6105 patients with a history of stroke or transient ischemic attack. Controls were matched for age, treatment group, sex, region, and most recent qualifying event at entry to the parent trial. RESULTS: IL-6 and TNF-alpha, but not IL-18, were associated with risk of recurrent ischemic stroke independently of conventional risk markers. Adjusted odds ratios comparing the highest to lowest third of their distributions were 1.33 (95% CI, 1.00 to 1.78) for IL-6 and 1.46 (1.02 to 2.10) for TNF-alpha. No inflammatory marker was associated with hemorrhagic stroke risk. In multivariable models, IL-6 and TNF-alpha fully explained observed associations of C-reactive protein and fibrinogen with risk of ischemic stroke, but TNF-alpha retained borderline significance after full adjustment. CONCLUSIONS: Inflammatory markers associated with the acute-phase response (IL-6, TNF-alpha, C-reactive protein, and fibrinogen, but not IL-18) are associated with risk of recurrent stroke. These markers are dependent on each other in multivariable models, and once all were included, only TNF-alpha retained a borderline association. Markers of generalized inflammation of the acute-phase response are associated with recurrent stroke, rather than IL-6, C-reactive protein, or fibrinogen in particular. |
| spellingShingle | Welsh, P Lowe, G Chalmers, J Campbell, D Rumley, A Neal, B MacMahon, S Woodward, M Associations of proinflammatory cytokines with the risk of recurrent stroke. |
| title | Associations of proinflammatory cytokines with the risk of recurrent stroke. |
| title_full | Associations of proinflammatory cytokines with the risk of recurrent stroke. |
| title_fullStr | Associations of proinflammatory cytokines with the risk of recurrent stroke. |
| title_full_unstemmed | Associations of proinflammatory cytokines with the risk of recurrent stroke. |
| title_short | Associations of proinflammatory cytokines with the risk of recurrent stroke. |
| title_sort | associations of proinflammatory cytokines with the risk of recurrent stroke |
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