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IL-6 and Surgical Outcomes in Carotid Endarterectomy

2025-12Recensão Acesso aberto
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dc.contributor.authorRocha-Melo-Sousa, Antónia
dc.contributor.authorBrazuna, Márcio
dc.contributor.authorTavares, Carmen
dc.contributor.authorGuduru, Sai
dc.contributor.authorFragão-Marques, Mariana
dc.contributor.authorRocha-Neves, João
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblMDPI - Multidisciplinary Digital Publishing Institute
dc.date.accessioned2026-01-23T10:53:01Z
dc.date.available2026-01-23T10:53:01Z
dc.date.issued2025-12
dc.description.abstractBackground: Interleukin-6 (IL-6) is a key inflammatory cytokine implicated in atherosclerotic plaque progression and carotid vulnerability. Although elevated IL-6 levels have been linked to cerebrovascular risk, its prognostic value in patients undergoing carotid endarterectomy (CEA) remains undefined. This systematic review aimed to investigate the available evidence on the relationship between IL-6 levels, surgical outcomes and mechanistic evidence in CEA patients. Materials and Methods: The review followed the PRISMA statement and AMSTAR-2 critical appraisal guidelines, with the protocol registered on PROSPERO (CRD420251120023). PubMed/MEDLINE, Scopus, and Web of Science were systematically searched up to July 2025 using the terms “interleukin-6” and “carotid endarterectomy”. Original studies in humans assessing IL-6 in relation to clinical outcomes after CEA or mechanistic evidence were included without language or date restrictions. Study quality was evaluated using the Cochrane Risk of Bias 2 and NHLBI tools, and evidence certainty was appraised using the GRADE framework. Given the heterogeneity of studies, only a qualitative synthesis was performed. Results: From 1232 records identified, 13 studies encompassing 1396 patients met the inclusion criteria. Most were prospective observational cohorts, with a mean participant age of 68.52 years and 81.16% male predominance. Perioperative stroke and mortality rates were uniformly low (≤2%), consistent with contemporary registry data. Across studies, elevated IL-6 levels—whether systemic or plaque-derived—were consistently associated with symptomatic carotid disease, plaque vulnerability, and adverse long-term outcomes. However, not all studies presented quantitative data on IL-6 levels, limiting the ability to draw definitive prognostic conclusions. Conclusions: Current evidence supports a mechanistic link between IL-6–mediated inflammation and carotid plaque instability, yet robust clinical validation in surgical populations is lacking. Future large-scale, prospective studies incorporating IL-6 measurement are warranted to establish its prognostic utility, guide anti-inflammatory therapeutic strategies, and refine postoperative risk stratification in patients undergoing CEA.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent1404723
dc.identifier.doi10.3390/medsci13040325
dc.identifier.issn2076-3271
dc.identifier.otherPURE: 149194005
dc.identifier.otherPURE UUID: 8e606998-01b0-4157-99bf-9894780afc9b
dc.identifier.otherScopus: 105025739485
dc.identifier.otherPubMed: 41440557
dc.identifier.otherWOS: 001647020000001
dc.identifier.urihttp://hdl.handle.net/10362/199677
dc.identifier.urlhttps://www.scopus.com/pages/publications/105025739485
dc.language.isoeng
dc.peerreviewedyes
dc.subjectatherosclerosis
dc.subjectbiomarkers
dc.subjectcarotid artery diseases
dc.subjectcytokines
dc.subjectprognosis
dc.subjectrisk factors
dc.subjectGeneral Medicine
dc.titleIL-6 and Surgical Outcomes in Carotid Endarterectomyen
dc.title.subtitleA Systematic Reviewen
dc.typereview
degois.publication.issue4
degois.publication.titleMedical sciences
degois.publication.volume13
dspace.entity.typePublication
rcaap.rightsopenAccess

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