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

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Fältnamn	Indikatorer	Metadata
000		04706naa a2200553 4500
001		oai:DiVA.org:uu-430329
003		SwePub
008		210108s2020 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4303292 URI
024	7	a https://doi.org/10.1111/jth.149472 DOI
040		a (SwePub)uu
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Aulin, Juliau Uppsala universitet,Institutionen för medicinska vetenskaper,Uppsala kliniska forskningscentrum (UCR)4 aut0 (Swepub:uu)julau101
245	1 0	a Serial measurement of interleukin-6 and risk of mortality in anticoagulated patients with atrial fibrillation :b Insights from ARISTOTLE and RE-LY trials.
264	1	b Elsevier BV,c 2020
338		a electronic2 rdacarrier
520		a BACKGROUND: The inflammatory biomarker interleukin-6 (IL-6) is associated with mortality in atrial fibrillation (AF).OBJECTIVE: To investigate if repeated IL-6 measurements improve the prognostication for stroke or systemic embolism, major bleeding, and mortality in anticoagulated patients with AF.METHODS: 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.RESULTS: 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 1.32 (95% confidence interval, 1.23-1.41; P < .0001) in ARISTOTLE, and 1.11 (1.01-1.22, P = .0290) in RE-LY; with improved C index from 0.74 to 0.76 in ARISTOTLE, but not in the smaller RE-LY cohort. There were no consistent associations with second IL-6 and stroke or systemic embolism, or major bleeding.CONCLUSIONS: Persistent systemic inflammatory activity, assessed by repeated IL-6 measurements, is associated with mortality independent of established clinical risk factors and other strong cardiovascular biomarkers in anticoagulated patients with AF.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
653		a anticoagulants
653		a atrial fibrillation
653		a inflammation
653		a interleukin-6
653		a mortality
653		a stroke
700	1	a Hijazi, Ziadu Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi4 aut0 (Swepub:uu)ziahi940
700	1	a Siegbahn, Agneta,d 1947-u Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Klinisk kemi,UCR4 aut0 (Swepub:uu)agsie424
700	1	a Andersson, Ulrikau Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)4 aut0 (Swepub:uu)ulran224
700	1	a Alexander, John H4 aut
700	1	a Connolly, Stuart J4 aut
700	1	a Ezekowitz, Michael D4 aut
700	1	a Gersh, Bernard J4 aut
700	1	a Granger, Christopher B4 aut
700	1	a Horowitz, John4 aut
700	1	a Hylek, Elaine M4 aut
700	1	a Lopes, Renato D4 aut
700	1	a Yusuf, Salim4 aut
700	1	a Wallentin, Lars,d 1943-u Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),UCR4 aut0 (Swepub:uu)larswall
700	1	a Oldgren, Jonas,d 1964-u Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi4 aut0 (Swepub:uu)jonaoldg
710	2	a Uppsala universitetb Institutionen för medicinska vetenskaper4 org
773	0	t Journal of Thrombosis and Haemostasisd : Elsevier BVg 18:9, s. 2287-2295q 18:9<2287-2295x 1538-7933x 1538-7836
856	4	u https://doi.org/10.1111/jth.14947y Fulltext
856	4	u https://uu.diva-portal.org/smash/get/diva2:1515351/FULLTEXT01.pdfx primaryx Raw objecty fulltext:print
856	4	u https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/jth.14947
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-430329
856	4 8	u https://doi.org/10.1111/jth.14947

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Av författaren/redakt...: Aulin, Julia; Hijazi, Ziad; Siegbahn, Agneta ...; Andersson, Ulrik ...; Alexander, John ...; Connolly, Stuart ...; visa fler...; Ezekowitz, Micha ...; Gersh, Bernard J; Granger, Christo ...; Horowitz, John; Hylek, Elaine M; Lopes, Renato D; Yusuf, Salim; Wallentin, Lars, ...; Oldgren, Jonas, ...; visa färre...

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