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Current Neurovascular Research

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ISSN (Print): 1567-2026
ISSN (Online): 1875-5739

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Research Article

The Role of Thrombo-inflammatory Biomarkers in the Prognosis of Cerebral Venous Sinus Thrombosis

Author(s): Serap Zengin Karahan*, Sibel Gazioglu, Irem Dilaver and Cavit Boz

Volume 18, Issue 2, 2021

Published on: 07 June, 2021

Page: [237 - 243] Pages: 7

DOI: 10.2174/1567202618666210607151518

Price: $65

Abstract

Background: The role of inflammation in the prognosis of cerebral venous sinus thrombosis (CVST) has been demonstrated in a small number of studies. The platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and the systemic immune-inflammatory index (SII) have been studied as prognostic inflammatory biomarkers in numerous thrombo-embolic diseases. However, the number of studies evaluating the relationship between these parameters and CVST is very low.

Objective: The purpose of this retrospective study was to investigate the relationship between PLR, NLR, and SII values on admission and long-term prognosis in patients with CVST in the acute-subacute period.

Methods: Fifty-one patients diagnosed with CVST and 51 healthy controls were included in the study. The patient and control groups were compared in terms of NLR, PLR, and SII values. Patients were classified into good and poor prognosis groups based on sixth-month modified Rankin scale scores (mRS) (0-2: good prognosis, 3-6: poor prognosis). Clinical and radiological features and PLR, NLR, and SII values were compared between the good and poor prognosis groups. Multivariate logistic regression analysis was used to identify independent prognostic factors for poor prognosis. The Receiver Operating Curve (ROC) was used to demonstrate the predictive power of PLR, NLR, and SII.

Results: Higher NLR and SII emerged as independent factors for poor prognosis in patients with CVST. NLR was the strongest parameter in predicting poor prognosis in CVST (AUC: 0.817, 95% CI: 0.63-1.00, sensitivity 70%, specificity 92.7%, p:0.002).

Conclusion: Higher NLR and SII on admission may be a predictor of long-term poor prognosis in patients with acute-subacute CVST.

Keywords: Inflammation, thrombosis, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immune- inflammatory index(SII), prognosis, cerebral venous sinus thrombosis.

« Previous Next »
[1]
Sader N, de Lotbinière-Bassett M, Tso MK, Hamilton M. Management of venous sinus thrombosis. Neurosurg Clin N Am 2018; 29(4): 585-94.
[http://dx.doi.org/10.1016/j.nec.2018.06.011] [PMID: 30223971]
[2]
Coutinho JM. Cerebral venous thrombosis. J Thromb Haemost 2015; 13(Suppl. 1): S238-44.
[http://dx.doi.org/10.1111/jth.12945] [PMID: 26149030]
[3]
Tufano A, Guida A, Coppola A, et al. Risk factors and recurrent thrombotic episodes in patients with cerebral venous thrombosis. Blood Transfus 2014; 12(Suppl 1): s337-42.
[4]
Ferro JM, Canhão P. Cerebral venous sinus thrombosis: Update on diagnosis and management. Curr Cardiol Rep 2014; 16(9): 523.
[http://dx.doi.org/10.1007/s11886-014-0523-2] [PMID: 25073867]
[5]
Wang L, Chen H, Zhang Y, et al. Clinical characteristics of cerebral venous sinus thrombosis in patients with systemic lupus erythematosus: A single-center experience in China. J Immunol Res 2015; 2015: 540738.
[http://dx.doi.org/10.1155/2015/540738] [PMID: 26090493]
[6]
Riva N, Donadini MP, Ageno W. Epidemiology and pathophysiology of venous thromboembolism: Similarities with atherothrombosis and the role of inflammation. Thromb Haemost 2015; 113(6): 1176-83.
[http://dx.doi.org/10.1160/TH14-06-0563] [PMID: 25472800]
[7]
Heestermans M, Salloum-Asfar S, Salvatori D, et al. Role of platelets, neutrophils, and factor XII in spontaneous venous thrombosis in mice. Blood 2016; 127(21): 2630-7.
[http://dx.doi.org/10.1182/blood-2015-10-672766] [PMID: 26932804]
[8]
Pfeiler S, Stark K, Massberg S, Engelmann B. Propagation of thrombosis by neutrophils and extracellular nucleosome networks. Haematologica 2017; 102(2): 206-13.
[http://dx.doi.org/10.3324/haematol.2016.142471] [PMID: 27927771]
[9]
Tokgoz S, Keskin S, Kayrak M, Seyithanoglu A, Ogmegul A. Is neutrophil/lymphocyte ratio predict to short-term mortality in acute cerebral infarct independently from infarct volume? J Stroke Cerebrovasc Dis 2014; 23(8): 2163-8.
[http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2014.04.007] [PMID: 25106834]
[10]
Azab B, Zaher M, Weiserbs KF, et al. Usefulness of neutrophil to lymphocyte ratio in predicting short- and long-term mortality after non-ST-elevation myocardial infarction. Am J Cardiol 2010; 106(4): 470-6.
[http://dx.doi.org/10.1016/j.amjcard.2010.03.062] [PMID: 20691303]
[11]
Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res 2014; 20(23): 6212-22.
[http://dx.doi.org/10.1158/1078-0432.CCR-14-0442] [PMID: 25271081]
[12]
Yang R, Chang Q, Meng X, Gao N, Wang W. Prognostic value of systemic immune-inflammation index in cancer: A meta-analysis. J Cancer 2018; 9(18): 3295-302.
[http://dx.doi.org/10.7150/jca.25691] [PMID: 30271489]
[13]
Yang YL, Wu CH, Hsu PF, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest 2020; 50(5): e13230.
[http://dx.doi.org/10.1111/eci.13230] [PMID: 32291748]
[14]
Li S, Liu K, Gao Y, et al. Prognostic value of systemic immune-inflammation index in acute/subacute patients with cerebral venous sinus thrombosis. Stroke Vasc Neurol 2020; 5(4): 368-73.
[http://dx.doi.org/10.1136/svn-2020-000362] [PMID: 32586971]
[15]
Tekesin A, Tunç A. Inflammatory markers are beneficial in the early stages of cerebral venous thrombosis. Arq Neuropsiquiatr 2019; 77(2): 101-5.
[http://dx.doi.org/10.1590/0004-282x20190001] [PMID: 30810594]
[16]
Akboga YE, Bektas H, Anlar O. Usefulness of platelet to lymphocyte and neutrophil to lymphocyte ratios in predicting the presence of cerebral venous sinus thrombosis and in-hospital major adverse cerebral events. J Neurol Sci 2017; 380: 226-9.
[http://dx.doi.org/10.1016/j.jns.2017.07.036] [PMID: 28870575]
[17]
Zheng B, Wang Q, Rajeev S, et al. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) at admission are predictors for worse functional outcome in cerebral venous sinus thrombosis. Blood 2020; 136: 8-9.
[http://dx.doi.org/10.1182/blood-2020-138963]
[18]
Wang L, Duan J, Bian T, et al. Inflammation is correlated with severity and outcome of cerebral venous thrombosis. J Neuroinflammation 2018; 15(1): 329.
[http://dx.doi.org/10.1186/s12974-018-1369-0] [PMID: 30477534]
[19]
Aguiar de Sousa D, Pereira-Santos MC, Serra-Caetano A, et al. Blood biomarkers associated with inflammation predict poor prognosis in cerebral venous thrombosis: A multicenter prospective observational study. Eur J Neurol 2021; 28(1): 202-8.
[http://dx.doi.org/10.1111/ene.14526] [PMID: 32918842]
[20]
Kyrle PA, Eichinger S. Deep vein thrombosis. Lancet 2005; 365(9465): 1163-74.
[http://dx.doi.org/10.1016/S0140-6736(05)71880-8] [PMID: 15794972]
[21]
Qun S, Tang Y, Sun J, et al. Neutrophil-to-lymphocyte ratio predicts 3-month outcome of acute ischemic stroke. Neurotox Res 2017; 31(3): 444-52.
[http://dx.doi.org/10.1007/s12640-017-9707-z] [PMID: 28181171]
[22]
Haybar H, Shokuhian M, Bagheri M, Davari N, Saki N. Involvement of circulating inflammatory factors in prognosis and risk of cardiovascular disease. J Mol Cell Cardiol 2019; 132: 110-9.
[http://dx.doi.org/10.1016/j.yjmcc.2019.05.010] [PMID: 31102585]
[23]
Kuplay H, Erdoğan SB, Bastopcu M, Arslanhan G, Baykan DB, Orhan G. The neutrophil-lymphocyte ratio and the platelet-lymphocyte ratio correlate with thrombus burden in deep venous thrombosis. J Vasc Surg Venous Lymphat Disord 2020; 8(3): 360-4.
[http://dx.doi.org/10.1016/j.jvsv.2019.05.007] [PMID: 31405801]
[24]
Rust R, Hofer AS, Schwab ME. Stroke promotes systemic endothelial inflammation and atherosclerosis. Trends Mol Med 2018; 24(7): 593-5.
[http://dx.doi.org/10.1016/j.molmed.2018.04.008] [PMID: 29747910]
[25]
Arenillas JF. Intracranial atherosclerosis and inflammation: Lessons from the East and the west. Brain Circ 2015; 1: 47-52.
[http://dx.doi.org/10.4103/2394-8108.162531]
[26]
Hu D, Ding C, Jiang X, et al. Elevated levels of inflammation markers predict poor outcomes in acute ischemic stroke patients after intravenous thrombolysis. J Stroke Cerebrovasc Dis 2021; 30(3): 105587.
[http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.105587] [PMID: 33450606]
[27]
Menon G, Johnson SE, Hegde A, Rathod S, Nayak R, Nair R. Neutrophil to lymphocyte ratio - a novel prognostic marker following spontaneous intracerebral haemorrhage. Clin Neurol Neurosurg 2021; 200: 106339.
[http://dx.doi.org/10.1016/j.clineuro.2020.106339] [PMID: 33183885]
[28]
von Brühl ML, Stark K, Steinhart A, et al. Monocytes, neutrophils, and platelets cooperate to initiate and propagate venous thrombosis in mice in vivo. J Exp Med 2012; 209(4): 819-35.
[http://dx.doi.org/10.1084/jem.20112322] [PMID: 22451716]
[29]
Rashad S, Niizuma K, Sato-Maeda M, et al. Early BBB breakdown and subacute inflammasome activation and pyroptosis as a result of cerebral venous thrombosis. Brain Res 2018; 1699: 54-68.
[http://dx.doi.org/10.1016/j.brainres.2018.06.029] [PMID: 29981290]
[30]
de Bruijn SF, de Haan RJ, Stam J. Clinical features and prognostic factors of cerebral venous sinus thrombosis in a prospective series of 59 patients. J Neurol Neurosurg Psychiatry 2001; 70(1): 105-8.
[http://dx.doi.org/10.1136/jnnp.70.1.105] [PMID: 11118257]
[31]
Kowoll CM, Kaminski J, Weiß V, et al. Severe cerebral venous and sinus thrombosis: Clinical course, imaging correlates, and prognosis. Neurocrit Care 2016; 25(3): 392-9.
[http://dx.doi.org/10.1007/s12028-016-0256-8] [PMID: 27000641]
[32]
Duan J, Leng X, Han Z, et al. Identifying biomarkers associated with venous infarction in acute/subacute cerebral venous thrombosis. Aging Dis 2021; 12(1): 93-101.
[http://dx.doi.org/10.14336/AD.2020.0405] [PMID: 33532130]

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