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Early Inflammatory Biomarkers Associated With Functional Outcomes in Acute Cerebral Venous Thrombosis: CLOT-VENUS
Leonardo Cruz-Criollo1, Milagros Galecio-Castillo1, Aaron Rodriguez-Calienes1,2
1Department of Neurology, University of Iowa Health Care, Iowa City (L.C.-C., M.G.-C., A.R.-C., P.K., A.B., J.G., J.L., J.C., N.A., A.S.).
Stroke
|April 22, 2026
Summary
Elevated inflammatory biomarkers like the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (PLR) predict poor outcomes in acute cerebral venous thrombosis. These markers can help stratify patient risk for better management.
Area of Science:
- Neurology
- Immunology
- Biomarker Research
Background:
- Inflammatory serum biomarkers are linked to outcomes in cerebrovascular diseases.
- The prognostic value of these markers in cerebral venous thrombosis (CVT) is not well-established.
Purpose of the Study:
- To assess the prognostic value of inflammatory biomarkers in acute CVT.
- To identify optimal thresholds and validate predictive performance for patient outcomes.
Main Methods:
- Retrospective observational cohort study of adults with acute CVT from the CLOT-VENUS registry.
- Calculation of neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) from admission blood counts.
- Analysis of functional status at 6 months (modified Rankin Scale) and mortality, using multivariable logistic regression and receiver operating characteristic analysis.
Main Results:
- Elevated neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, PLR, and SII at admission were associated with poor functional status at discharge and 6 months.
- Optimal cutoffs identified for predicting poor outcomes at 6 months: NLR >4.88, MLR >0.54, PLR >161.04, SII >1388.58.
- PLR and SII significantly predicted mortality at both discharge and 6 months.
Conclusions:
- Elevated admission levels of NLR, MLR, PLR, and SII are independently associated with poor outcomes in acute CVT.
- These accessible biomarkers can assist in early risk stratification for patients with CVT.
- Further research is needed to validate these biomarkers in clinical models for personalized management.
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