Interleukin-6,fibrinogen,and collateral circulation grading:predictors of cerebral hypoperfusion in acute ischemic stroke
CHEN Xiaowei
LIU Kun
LIU Youyuan
SUBINU Amir
Abstract：Objective To investigate the effects of interleukin-6(IL-6),fibrinogen(FIB),and ASPECTS collateral circulation grading on cerebral hypoperfusion(CH)in patients with acute ischemic stroke(AIS)and their combined predictive value.Methods A retrospective analysis was conducted on 360 AIS patients admitted between July 2018 and December 2024.Patients were divided into a CH group(180 patients)and a non-CH group(180 patients)based on dynamic susceptibility contrast-enhanced perfusion-weighted imaging(DSC-PWI).Baseline characteristics,time intervals,IL-6,FIB levels,and ASPECT collateral circulation scores were compared between the two groups.Multivariate logistic regression analysis identified independent predictors of CH,and a combined predictive model of IL-6 and FIB was constructed.Spearman correlation analysis was performed to assess the relationship between time from symptom onset to blood sampling(≤12 h and>12 h)and IL-6/FIB levels.Results The CH group exhibited significantly higher median levels of IL-6(8.18 pg/mL vs 5.57 pg/mL)and FIB(5.53 g/L vs 3.51 g/L)compared to the non-CH group(both P<0.001).The non-CH group had higher proportions of ASPECT collateral circulation grade 4(16.67%vs 4.44%)and grade 5(9.44%vs 1.67%).Multivariate analysis revealed that IL-6(OR=1.505,95%CI:1.333-1.701)and FIB(OR=1.354,95%CI:1.208-1.518)were independent risk factors for CH,while ASPECT grades 4(OR=0.202,95%CI:0.060-0.681)and 5(OR=0.187,95%CI:0.040-0.875)were protective factors.ROC curve analysis showed that the combination of IL-6 and FIB achieved an AUC of 0.823(95%CI:0.780-0.865)with 81.1%sensitivity and 71.1%specificity.IL-6 increased with FIB levels(r=0.170,P=0.001),but neither IL-6 nor FIB showed a linear correlation with time from symptom onset to blood sampling(≤12 h or>12 h).Conclusions IL-6 and FIB synergistically promote CH in AIS patients,while ASPECT collateral circulation grades 4 and 5 exert protective effects.The combination of IL-6 and FIB provides an effective serological tool for predicting CH risk,supporting early clinical intervention.
Keywords：acute ischemic strokecerebral hypoperfusioncollateral circulationinterleukin-6fibrinogen
Publication Date：2025-10-28
Online Publishing Date：2025-10-09(First online date of this platform, not the publication date of the document)
Pages：7( 28-34 )