Interleukin-6 Predicts Carotid Plaque Severity, Vulnerability, and Progression.

Area of Science:

• Cardiovascular Medicine
• Immunology
• Neurology

Background:

• Interleukin-6 (IL-6) plays a significant role in the pathophysiology of atherosclerosis.
• The potential of anti-IL-6 therapy for stroke prevention in carotid atherosclerosis patients requires further investigation.

Purpose of the Study:

• To assess whether circulating IL-6 levels can predict carotid plaque severity, vulnerability, and progression.
• To evaluate the potential of IL-6 as a biomarker for identifying patients who may benefit from anti-IL-6 therapy for stroke prevention.

Main Methods:

• Prospective population-based Cardiovascular Health Study (CHS) involving 4334 participants.
• Carotid ultrasound at baseline and 5 years to assess plaque severity, vulnerability, and progression.
• Multivariable regression models used to analyze the relationship between baseline plasma IL-6 levels and plaque characteristics, controlling for atherosclerosis risk factors.

Main Results:

• Elevated IL-6 levels significantly predicted increased carotid plaque severity (β=0.09, P=1.3×10⁻³).
• IL-6 was associated with plaque vulnerability (OR, 1.21; P=7.4×10⁻³) and progression (OR, 1.44; P=9.1×10⁻⁶).
• A threshold of 2.0 pg/mL IL-6 was identified in participants with a high predicted probability of plaque progression.

Conclusions:

• Circulating IL-6 is a reliable predictor of carotid plaque severity, vulnerability, and progression.
• The identified IL-6 cutoff (2.0 pg/mL) may aid in selecting patients for anti-IL-6 therapy to prevent strokes.