Association between inflammatory biomarkers and venous thromboembolism: a systematic review and meta-analysis

Abstract

Background: Venous thromboembolism (VTE) is a common thrombotic vascular disease that has a significant impact on people’s well-being and quality of life. A plethora of clinical studies explore the relationship between inflammatory biomarkers and VTE but yield conflicting results. This article proposed to pool these studies to draw a more convincing conclusion. Methods: We searched several databases for studies before April 2023. Available data was processed using Stata software (version 15.0 SE) and R (version 4.1.2). This meta-analysis has been registered in PROSPERO (CRD42022321815). The VTE in this review encompassed pulmonary embolism, deep vein thrombosis, and cerebral venous thrombosis. Results: A total of 25 articles were finally involved in this study. Our results revealed that higher levels of high-sensitivity C-reactive protein (hs-CRP, MD, 0.63, 95%CI, 0.21—1.05) and C-reactive protein (CRP)> 3ug/ml (OR, 1.52, 95%CI, 1.18—1.96) might be regarded as risk factors for future VTE occurrence. The elevated levels of monocyte (MD, 0.03, 95%CI, 0.00—0.05), hs-CRP (0.85, 0.61—1.08), CRP (0.66, 0.20—1.13) and IL-6 (0.47, 0.25—0.70) might represent the previous VTE; a series of markers such as white blood cell (1.43, 0.88—1.98), neutrophil (1.79, 1.02—2.56), monocyte (0.17, 0.14—0.21), hs-CRP (3.72, 1.45—5.99), IL−6 (5.99, 4.52—7.46), platelet-lymphocyte ratio (33.1, 24.45—41.78) and neutrophil-lymphocyte ratio (1.34, 0.95—1.73) increased during the acute phase of VTE. Conclusions: In general, activated inflammatory biomarkers might not only be correlated with an increased risk of VTE, but may also give a hint of the occurrence of VTE in clinical settings.