Endothelial receptor proteins in acute venous thrombosis and delayed thrombus resolution in cerebral sinus thrombosis

Background and Purpose: Cerebral sinus venous thrombosis (CSVT) is a rare but life-threatening disease and its diagnosis remains challenging. Blood biomarkers, including D-Dimer are currently not recommended in guidelines. Soluble endothelial receptor proteins (sICAM-1, sPECAM-1 and sVCAM-1) have been shown to be promising diagnostic biomarkers in deep-vein-thrombosis (DVT) and pulmonary embolism (PE), however, their role in acute CSVT remains unclear. Methods: In this bi-center, prospective study we quantified D-Dimer and sICAM-1, sPECAM-1 and sVCAM-1 in plasma of patients with clinically suspected CSVT managed in the neurological emergency department (ED) of a tertiary care hospital. All patients underwent cerebral magnetic resonance imaging (MRI) and were followed up after 3, 6 and 12 months to detect thrombus resolution. Results: Twenty-four out of 75 (32%) patients with clinically suspected CSVT presenting with headache to the ED were diagnosed of acute CSVT. These patients had a mean age of 45 ? 16 years and 78% were female. In patients with CSVT, mean baseline D-dimer (p<0.001) and sPECAM-1 (p<0.001) was significantly higher compared to patients without CSVT. The combination of D-Dimer and sPECAM-1 yielded the best ROC-AUC (0.994;? 198ng/ml) on admission were associated with delayed venous thrombus resolution at 3 months (AUC = 0.83). Conclusion: sPECAM-1 in combination with D-Dimer may be used to improve the diagnostic accuracy of acute CSVT and sPECAM-1 may predict longterm radiologic outcome of CSVT. Confirmatory results are needed in other settings in order to proof their value in the management concept of CSVT patients. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement no funding was received ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was approved by the local ethical review board (Ethik-Kommission Land Oberösterreich;108 EK-58-17). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data that support the findings of this study are available on request from the author