Prognostic Value of Interleukin‐6 and High‐Sensitivity C‐Reactive Protein in Stroke Associated With Intracranial Atherosclerotic Stenosis

Background Intracranial atherosclerotic stenosis (ICAS) is a major cause of ischemic stroke with a high recurrence risk despite guideline‐based secondary prevention. Although inflammation may contribute to this residual risk, the prognostic roles of interleukin‐6 (IL‐6) and hsCRP (high‐sensitivity C‐reactive protein) in ICAS‐related stroke remain unclear. Methods This prospective observational study enrolled 942 patients with ischemic stroke within 1 week of onset. ICAS was defined as ≥50% stenosis/occlusion. High IL‐6 and hsCRP levels were defined using median cutoffs of ≥4.2 pg/mL and ≥2.0 mg/L, respectively. The primary end point was 1‐year major adverse cardiovascular events (MACE), including nonfatal stroke, nonfatal acute coronary syndrome, and vascular death. Results Of the 942 patients (mean age; 71.2 years, men; 61.3%), 262 (27.8%) had ICAS. Among patients with ICAS, elevated IL‐6 and hsCRP were each associated with higher MACE rates (IL‐6: 15.4% versus 28.8%, log‐rank P=0.012; hsCRP: 15.9% versus 28.5%, log‐rank P=0.015). After multivariate adjustment, hsCRP ≥2.0 mg/L remained independently associated with MACE (hazard ratio [HR], 2.01; 95% CI, 1.12–3.59), whereas the association for IL‐6≥4.2 pg/mL was attenuated (HR, 1.75; 95% CI, 0.95–3.23). Both biomarkers were associated with MACE in patients achieving low‐density lipoprotein cholesterol