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CC BY 4.0 · Arq Neuropsiquiatr 2024; 82(05): s00441787137
DOI: 10.1055/s-0044-1787137
Original Article

Inflammatory biomarkers are correlated with thrombus burden in cerebral venous sinus thrombosis

Biomarcadores inflamatórios estão relacionados à carga trombótica na trombose venosa cerebral
Aslı Yaman Kula 
1   Bezmialem Foundation University, Faculty of Medicine, Department of Neurology, Istanbul, Turkey.
,
Ahmet Volkan Kurtoğlu 
1   Bezmialem Foundation University, Faculty of Medicine, Department of Neurology, Istanbul, Turkey.
,
Vildan Güzel 
1   Bezmialem Foundation University, Faculty of Medicine, Department of Neurology, Istanbul, Turkey.
,
Serdar Balsak 
2   Bezmialem Foundation University, Faculty of Medicine, Department of Radiology, Istanbul, Turkey.
,
Ayşegül Yabacı Tak 
3   Bezmialem Foundation University, Faculty of Medicine, Department of Biostatistics, Istanbul, Turkey.
,
Talip Asil 
4   Memorial Hizmet Hospital, Department of Neurology, Istanbul, Turkey.
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Abstract

Background Increasing evidence suggests that inflammatory biomarkers play a significant role in cerebral venous sinus thrombosis (CVST). The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) are related to thrombotic conditions and indicators of systemic inflammation.

Objective To analyze the correlation between inflammatory biomarkers and the extent of thrombus, determined by the CVST-Score.

Methods A total of 40 patients with CVST (24 female subjects; 60%) and 40 age- and sex-matched healthy controls were retrospectively evaluated. Inflammatory biomarkers, including C-reactive protein (CRP), PLR, NLR, MLR, and the CVST-Score, were recorded to assess the relationship between biomarkers and thrombus burden. The patients were grouped according to symptom duration (group 1: 0–3 days; group 2: 4–7 days; and group 3: 8–30 days) to compare biomarker levels.

Results The CRP, NLR, and PLR were significantly higher in the CVST group (p < 0.001; p = 0.003; p = 0.014 respectively). The NLR and PLR presented a significant positive correlation with the CVST-Score (p = 0.003, r = 0.464; p = 0.040, r = 0.326 respectively). The NLR was significantly higher in group 1 compared with groups 2 and 3 (p = 0.016 and p = 0.014 respectively). In group 1, there was a stronger positive correlation between the CVST-Score and the NLR (p = 0.026, r = 0.591) and the PLR (p = 0.012, r = 0.648). The multiple linear regression analysis revealed that the NLR is a key factor in predicting the CVST-Score (p = 0.019).

Conclusion The NLR and PLR are associated with thrombus burden in CVST, especially in patients admitted to the hospital in the early stages. The NLR is an independent factor to predict the thrombus burden in CVST.

Resumo

Antecedentes Há evidências crescentes de que biomarcadores inflamatórios desempenham um papel importante na trombose venosa cerebral (TVC). A razão neutrófilo-linfócito (NLR), a razão plaqueta-linfócito (PLR) e a razão monócito-linfócito (MLR) estão relacionadas a condições trombóticas e são indicadores de inflamação sistêmica.

Objetivo Analisar a correlação entre NLR, PLR, MLR e a extensão do trombo, determinada pelo escore de TVC.

Métodos Avaliamos retrospectivamente 40 pacientes com TVC (24 mulheres; 60%) e 40 controles pareados por idade e sexo. Biomarcadores inflamatórios, incluindo proteína C reativa (PCR), PLR, NLR, MLR e escore de TVC, foram registrados para avaliar a relação entre biomarcadores e carga trombótica. Os pacientes foram agrupados de acordo com a duração dos sintomas (grupo 1: 0–3 dias; grupo 2: 4–7 dias; e grupo 3: 8–30 dias) para a comparação dos níveis de biomarcadores.

Resultados A PCR, a NLR e a PLR foram significativamente maiores no grupo com TVC (p < 0,001; p = 0,003; e p = 0,014, respectivamente). A NLR e a PLR apresentaram correlação positiva significativa com o escore de TVC (p = 0,003, r = 0,464; e p = 0,040, r = 0,326, respectivamente). A NLR foi significativamente maior no grupo 1 em comparação aos grupos 2 e 3 (p = 0,016 e p = 0,014, respectivamente). No grupo 1, houve correlação mais forte entre o escore de TVC e a NLR (p = 0,026, r = 0,591) e a PLR (p = 0,012, r = 0,648). A análise de regressão linear múltipla identificou a NLR como fator-chave na predição do escore de TVC (p = 0,019).

Conclusão A NLR e a PLR estão associadas à carga trombótica na TVC, especialmente em pacientes admitidos precocemente, e a RNL é um fator independente na previsão da carga trombótica.

Keywords

Sinus Thrombosis, Intracranial - Biomarkers - Inflammation

Palavras-chave

Trombose dos Seios Intracranianos - Biomarcadores - Inflamação

Authors' Contributions

AYK, TA: conceptualization and design of the work, writing the manuscript; AVK, VG: data acquisition; AYT: analysis; SB: measurements on the imaging. All authors approved the final version of the manuscript and are responsible for all aspects of the work.




Publication History

Received: 06 September 2023

Accepted: 04 April 2024

Article published online:
29 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Aslı Yaman Kula, Ahmet Volkan Kurtoğlu, Vildan Güzel, Serdar Balsak, Ayşegül Yabacı Tak, Talip Asil. Inflammatory biomarkers are correlated with thrombus burden in cerebral venous sinus thrombosis. Arq Neuropsiquiatr 2024; 82: s00441787137.
DOI: 10.1055/s-0044-1787137
 

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