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

• Published in: Research and practice in thrombosis and haemostasis Vol. 7; no. 3; p. 100130
• Main Authors: 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
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2023; Wiley; Elsevier
• Subjects: cerebral venous sinus thrombosis; D-dimer; high-sensitivity C-reactive protein; Life Sciences; Neurons and Cognition; Original; thrombin generation assay; D-dimer; cerebral venous sinus thrombosis; high-sensitivity C-reactive protein; thrombin generation assay
• ISSN: 2475-0379; 2475-0379
• DOI: 10.1016/j.rpth.2023.100130

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. 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. 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 potential5pM 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. 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. •There are several clinical presentations of cerebral venous sinus thrombosis (CVST).•Association between inflammation and CVST severity has been observed.•D-dimer and C-reactive protein predicted bad prognosis in CVST.•Elevated endogenous thrombin potential on admission was associated with ischemic parenchymal lesions.