"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"

作者全名："Jia, Yiming; Zhang, Kaixin; Shi, Mengyao; Guo, Daoxia; Yang, Pinni; Bu, Xiaoqing; Chen, Jing; Wang, Aili; Xu, Tan; He, Jiang; Zhu, Zhengbao; Zhang, Yonghong"

作者地址："[Jia, Yiming; Zhang, Kaixin; Shi, Mengyao; Guo, Daoxia; Yang, Pinni; Wang, Aili; Xu, Tan; Zhu, Zhengbao; Zhang, Yonghong] Soochow Univ, Sch Publ Hlth, Dept Epidemiol, Suzhou Med Coll, 199 Renai Rd, Suzhou 215123, Jiangsu, Peoples R China; [Jia, Yiming; Zhang, Kaixin; Shi, Mengyao; Guo, Daoxia; Yang, Pinni; Wang, Aili; Xu, Tan; Zhu, Zhengbao; Zhang, Yonghong] Soochow Univ, Jiangsu Key Lab Prevent & Translat Med Geriatr Dis, Suzhou Med Coll, 199 Renai Rd, Suzhou 215123, Jiangsu, Peoples R China; [Shi, Mengyao; Chen, Jing; He, Jiang; Zhu, Zhengbao] Tulane Univ, Dept Epidemiol, Sch Publ Hlth & Trop Med, New Orleans, LA 70112 USA; [Guo, Daoxia] Soochow Univ, Sch Nursing, Suzhou Med Coll, Suzhou, Peoples R China; [Bu, Xiaoqing] Chongqing Med Univ, Sch Publ Hlth, Dept Epidemiol, Chongqing, Peoples R China; [Chen, Jing; He, Jiang] Tulane Univ, Dept Med, Sch Med, New Orleans, LA USA"

通信作者："Zhu, ZB; Zhang, YH (通讯作者)，Soochow Univ, Sch Publ Hlth, Dept Epidemiol, Suzhou Med Coll, 199 Renai Rd, Suzhou 215123, Jiangsu, Peoples R China.; Zhu, ZB; Zhang, YH (通讯作者)，Soochow Univ, Jiangsu Key Lab Prevent & Translat Med Geriatr Dis, Suzhou Med Coll, 199 Renai Rd, Suzhou 215123, Jiangsu, Peoples R China.; Zhu, ZB (通讯作者)，Tulane Univ, Dept Epidemiol, Sch Publ Hlth & Trop Med, New Orleans, LA 70112 USA."

来源：TRANSLATIONAL STROKE RESEARCH

ESI学科分类：NEUROSCIENCE & BEHAVIOR

WOS号：WOS:000998373500001

JCR分区：Q1

影响因子：6.9

年份：2023

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期号：　

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文献类型：Article; Early Access

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

摘要："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."

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