Blood biomarkers associated with inflammation predict poor prognosis in cerebral venous thrombosis.

BACKGROUND Experimental studies suggest inflammation can contribute to blood barrier disruption and brain injury in Cerebral Venous Thrombosis (CVT). We aimed to determine whether blood biomarkers of inflammation were associated with the evolution of brain lesions, persistent venous occlusion or functional outcome in patients with CVT. METHODS Pathophysiology of Venous Infarction-Prediction of Infarction and Recanalization in CVT (PRIORITy-CVT) was a multicenter prospective cohort study of patients with newly diagnosed CVT. Evaluation of neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) concentrations in peripheral blood samples collected at admission in 62 patients. Additional quantification of IL-6 was performed at 1, 3 and 8, in 35 patients and 22 healthy controls. Standardized MRI performed at day 1, 8 and 90. Primary outcomes were early evolution of brain lesion, early recanalization and functional outcome at 90-days. RESULTS IL-6 levels were increased in patients with CVT with a peak at baseline. IL-6, NLR and CRP levels were not related with brain lesion outcomes or early recanalization but had a significant association with unfavorable functional outcome at 90-days (IL-6: OR 1.28, 95%CI 1.05-1.56, p=0.046; NLR: OR 1.39, 95%CI 1.4-1.87, p=0.014; CRP: OR 1.756, 95%CI 1.010-3.051, p=0.029). Baseline IL-6 had the best discriminative capacity, with an area under the ROC curve to predict unfavorable functional outcome of 0.74 (p=0.031). CONCLUSIONS Increased baseline levels of NLR, CRP and IL-6 may serve as new predictive markers of worse functional prognosis at 90-days in patients with CVT. No association was found between inflammatory markers and early evolution of brain lesion or venous recanalization.