Abstract WP536: Elevated High-Sensitivity C-Reactive Protein and Serum Claudin-5 are Associated With Venous Infarction and/or Severity in Acute/Subacute Cerebral Venous Thrombosis

Abstract

Background and Purpose: Acute/subacute cerebral venous thrombosis (CVT) with venous infarction often has poorer outcomes than CVT alone. Exploring biomarkers relevant to venous infarction and CVT severity would contribute to improved therapy and prognosis of CVT patients with venous infarction. It remains unclear whether blood-brain barrier(BBB) related proteins and hs-CRP play a crucial role in the pathogenesis of CVT with venous thrombosis. Methods: 59 Patients were divided into four groups: acute/subacute CVT patients with venous infarct(ASVI group, n=30), acute/subacute CVT patients without venous infarct(ASOVI group, n=13), chronic CVT group(n=9) and control subjects(n=7). Hs-CRP, claudin-5, occludin, MMP-9, GFAP and S100B were measured on admission in serum and/or cerebrospinal fluid(CSF). Initial CVT severity was assessed by the NIHSS. Results: In ASVI group, only serum claudin-5 and hs-CRP were significantly higher than ASOVI group (3.15±1.20 vs. 2.41±0.57, p=0.025; 19.13±15.22 vs. 5.65±6.19, P=0.001, respectively). AUCs for serum claudin-5 and Hs-CRP did not have significant difference (0.70,[95%CI:0.54-0.86]vs.0.795[95%CI:0.66-0.93], P=0.409). AUC for the combination of serum claudin-5 and hs-CRP was greater than that for claudin-5 alone (0.86 [95%CI: 0.75-0.97]vs.0.70[95%CI:0.54-0.86],P=0.0352). After adjustment, serum claudin-5 (adjusted OR, 17.85 [95% CI: 1.23-258.62], P=0.035) and hs-CRP (adjusted OR, 29.22, [95% CI:2.15-397.46], P=0.011) were significantly associated with venous infarction. When serum claudin-5 and hs-CRP were greater than or equal to their cut-off values (2.74 mg/l and 10.97mg/l), 100% of patients had venous infarcts. In ASVI group, hs-CRP was positively associated with NIHSS ( r =0.640; 95%CI, 0.340- 0.821; P&lt 0.001). Conclusions: For acute/subacute CVT patients, s erum claudin-5 and hs-CRP may be clinically valuable biomarkers associated with venous infarction. Hs-CRP was correlated with CVT severity. Anti-inflammation therapy may be useful in the management of severe CVT patients.