C-reactive protein and D-dimer in cerebral vein thrombosis: Relation to clinical and imaging characteristics as well as outcomes in a French cohort study

INTRODUCTION: Cerebral venous sinus thrombosis (CVST) is a rare disease with highly variable clinical presentation and outcomes. Clinical studies suggest a role of inflammation and coagulation in CVST outcomes. The aim of this study was to investigate the association of inflammation and hypercoagula...

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Detalles Bibliográficos
Autores principales: Billoir, Paul, Siguret, Virginie, Fron, Elisabeth Masson, Drouet, Ludovic, Crassard, Isabelle, Marlu, Raphaël, Barbieux-Guillot, Marianne, Morange, Pierre-Emmanuel, Robinet, Emmanuelle, Metzger, Catherine, Wolff, Valérie, André-Kerneis, Elisabeth, Klapczynski, Frédéric, Martin-Bastenaire, Brigitte, Pico, Fernando, Menard, Fanny, Ellie, Emmanuel, Freyburger, Geneviève, Rouanet, François, Allano, Hong-An, Godenèche, Gaëlle, Mourey, Guillaume, Moulin, Thierry, Berruyer, Micheline, Derex, Laurent, Trichet, Catherine, Runavot, Gwénaëlle, Le Querrec, Agnès, Viader, Fausto, Cluet-Dennetiere, Sophie, Husein, Thomas Tarek, Donnard, Magali, Macian-Montoro, Francisco, Ternisien, Catherine, Guillon, Benoît, Laplanche, Sophie, Zuber, Mathieu, Peltier, Jean-Yves, Tassan, Philippe, Roussel, Bertrand, Canaple, Sandrine, Scavazza, Emilie, Gaillard, Nicolas, Triquenot Bagan, Aude, Le Cam Duchez, Véronique
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Original Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10149398/
https://www.ncbi.nlm.nih.gov/pubmed/37138790
http://dx.doi.org/10.1016/j.rpth.2023.100130
Descripción
Sumario:INTRODUCTION: Cerebral venous sinus thrombosis (CVST) is a rare disease with highly variable clinical presentation and outcomes. Clinical studies suggest a role of inflammation and coagulation in CVST outcomes. The aim of this study was to investigate the association of inflammation and hypercoagulability biomarkers with CVST clinical manifestations and prognosis. METHODS: This prospective multicenter study was conducted from July 2011 to September 2016. Consecutive patients referred to 21 French stroke units and who had a diagnosis of symptomatic CVST were included. High-sensitivity C-reactive protein (hs-CRP), neutrophil-to-lymphocyte ratio (NLR), D-dimer, and thrombin generation using calibrated automated thrombogram system were measured at different time points until 1 month after anticoagulant therapy discontinuation. RESULTS: Two hundred thirty-one patients were included. Eight patients died, of whom 5 during hospitalization. The day 0 hs-CRP levels, NLR, and D-dimer were higher in patients with initial consciousness disturbance than in those without (hs-CRP: 10.2 mg/L [3.6-25.5] vs 23.7 mg/L [4.8-60.0], respectively; NLR: 3.51 [2.15-5.88] vs 4.78 [3.10-9.59], respectively; D-dimer: 950 μg/L [520-2075] vs 1220 μg/L [950-2445], respectively). Patients with ischemic parenchymal lesions (n = 31) had a higher endogenous thrombin potential(5pM) than those with hemorrhagic parenchymal lesions (n = 31): 2025 nM min (1646-2441) vs 1629 nM min (1371-2090), respectively (P = .0082). Using unadjusted logistic regression with values >75th percentile, day 0 hs-CRP levels of >29.7 mg/L (odds ratio, 10.76 [1.55-140.4]; P = .037) and day 5 D-dimer levels of >1060 mg/L (odds ratio, 14.63 [2.28-179.9]; P = .010) were associated with death occurrence. CONCLUSION: Two widely available biomarkers measured upon admission, especially hs-CRP, could help predict bad prognosis in CVST in addition to patient characteristics. These results need to be validated in other cohorts.

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