Serum MPO-DNA for Predicting the Risk of Venous Thromboembolism and the Effect of Statins in Patients with Spontaneous Intracerebral Hemorrhage

Background: Patients with spontaneous intracerebral hemorrhage (ICH) are at high risk of venous thromboembolism (VTE). Recent studies have shown the involvement of Neutrophil Extracellular Traps (NETs) in thrombogenesis. Objectives: To explore the predictive value of serum MPO-DNA (a NETs surrogate) for VTE and the effect of statins on serum MPO-DNA levels and the VTE incidence in ICH patients. Methods: This prospective cohort study enrolled 117 ICH patients and 15 healthy controls. Serum MPO-DNA levels were measured via ELISA. The relationship between serum MPO-DNA levels and VTE risk was analyzed. The predictive value of MPO-DNA was evaluated by ROC curves. Statin effects on NETs and VTE incidence were evaluated. Results: The median MPO-DNA level in patients with VTE was 0.304(95% CI: 0.231-0.349), significantly higher than the 0.188(95% CI: 0.159-0.236) in non-VTE patients. Elevated MPO-DNA levels were associated with an increased VTE risk (OR 7.13, 95%CI 2.58 – 19.75; P< 0.001), and this association persisted after adjustment. The AUC values for MPO-DNA, CRP, and D-dimer were 0.824 (95% CI: 0.719-0.928), 0.618 (95% CI: 0.481-0.754), and 0.786 (95% CI: 0.683-0.888), respectively. Moreover, statin users exhibited reduced MPO-DNA levels (0.174 vs. 0.218; P=0.007), though VTE incidence differences (13.8% vs. 19.3%) lacked statistical significance. Conclusion: Serum MPO-DNA serves as a sensitive biomarker for VTE prediction in ICH, highlighting NETs as potential therapeutic targets. Statins could attenuate NETosis, but larger trials are required to validate their clinical efficacy and safety in VTE prevention for ICH patients.