Level and value of interleukin-18 after acute ischemic stroke

Chun Man Yuen, Cheng An Chiu, Li Teh Chang, Chia Wei Liou, Cheng Hsien Lu, Ali A. Youssef, Hon Kan Yip*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

46 Scopus citations


Background: The prognostic value of the level of interleukin (IL)-18 in patients after acute ischemic stroke (IS) has not been completely investigated. This prospective cohort study examined whether the circulating IL-18 level can predict 90-day outcome of IS. Methods and Results: Plasma IL-18 level was obtained from blood samples taken by venous access at 48 h following acute IS in 217 consecutive patients. Plasma IL-18 level was also evaluated in 20 healthy and 40 at-risk control subjects. Plasma levels of IL-18 and white blood cell (WBC) counts were significantly higher in IS patients than in both control groups (all p values <0.0001). Patients with high IL-18 level (≥780pg/ml) had significantly higher incidences of 90-day recurrent stroke and 90-day accumulative death (all p values <0.01). Univariate analysis demonstrated that IL-18 level (≥780pg/ml), modified Rankin scale score, WBC count, creatinine level, and coronary artery disease were significantly associated with 90-day major adverse clinical outcomes (MACO) (defined as combined 90-day recurrent stroke and 90-day mortality) (all p values <0.05). Multiple stepwise logistic regression analysis demonstrated that high IL-18 level (≥780pg/ml) (p<0.0001), together with creatinine level (p=0.024), were independently predictive of 90-day MACO. Conclusions: Plasma IL-18 level is a major independent inflammatory predictor of 90-day MACO in IS patients. Evaluation of circulating IL-18 level might improve the prediction of unfavorable clinical outcome following IS.

Original languageEnglish
Pages (from-to)1691-1696
Number of pages6
JournalCirculation Journal
Issue number11
StatePublished - 2007


  • Interleukin-18
  • Ischemic stroke
  • Major adverse clinical outcome


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