Futile reperfusion (FR) is common in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) treated with endovascular treatment (EVT). This study aimed to assess whether interleukin-10 (IL-10) level is associated with FR. From prospective DETECT2-China (Endovascular Treatment for Acute Ischemic Stroke in China) cohort, we screened consecutive patients with AIS-LVO who achieved successful recanalization and underwent IL-10 test within 24 h after EVT. FR was defined by poor functional outcome (mRS score ≥ 3 at 90 days) despite successful reperfusion (thrombolysis in cerebral infarction scale 2b/3). Eligible patients were divided into non-FR and FR groups. Logistic regression analysis was performed to evaluate the prediction of IL-10 on FR. A total of 124 patients were enrolled in final analysis, including 60 in non-FR group and 64 in FR group. Logistic regression analysis found that higher baseline NIHSS (14 [11, 18] vs. 17 [13, 21], unadjusted OR, 1.070; 95% CI, 1.012–1.131; P = 0.018; adjusted OR [aOR], 1.106; 95% CI, 1.009–1.213; P = 0.032), baseline serum glucose (12.92 [10.56, 15.41] vs. 15.98 [13.20, 21.71], unadjusted OR, 1.215; 95% CI, 1.079–1.368; P = 0.001; aOR, 1.256; 95% CI, 1.075–1.468; P = 0.004), and higher IL-10 level (2.04 [1.62, 2.39] vs. 2.33 [1.88, 5.84], unadjusted OR, 1.272; 95% CI, 1.047–1.547; P = 0.016; aOR, 2.173; 95% CI, 1.058–4.463; P = 0.035) were independent risk factors for FR. The combined model demonstrated an AUC of 0.862, which was significantly superior to individual markers (AUC: 0.657–0.729; all pairwise DeLong P < 0.05). IL-10 levels were independently associated with FR in AIS-LVO patients with successful endovascular recanalization after EVT, indicating its potential role as a novel prognostic biomarker for futile reperfusion in exploratory analysis. Clinical trial number: NCT05092139|| https://www.clinicaltrials.gov/ .
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