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Oblitas CM, Demelo-Rodríguez P, López-Rubio M, Lago-Rodríguez MO, García-Gámiz M, Zamora-Trillo A, Alvarez-Sala Walther LA, García-Martínez R, Galeano-Valle F. Evaluation of soluble P-selectin as a predictive biomarker in acute symptomatic pulmonary embolism: Insights from a prospective observational study. Eur J Haematol 2024; 113:201-207. [PMID: 38654526 DOI: 10.1111/ejh.14218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Soluble P-selectin (sP-selectin) has been proposed as a potential biomarker for venous thromboembolism (VTE) diagnosis with interesting results. However, its role in predicting early mortality in pulmonary embolism (PE) remains unexplored. METHODS This observational, prospective, single-center study enrolled consecutive patients aged 18 or older with confirmed acute symptomatic PE and no prior anticoagulation. The study aims to assess the prognostic capacity of sP-selectin measured at the time of PE diagnosis for short-term mortality and major bleeding. RESULTS A total of 196 patients, with a mean age of 69.1 years (SD 17), were included, of whom 52.6% were male. Within 30 days, 9.7% of patients (n = 19) died, and 5.1% (n = 10) suffered major bleeding. PE risk stratification revealed 4.6% (n = 9) with high-risk PE, 34.7% (n = 68) with intermediate-high-risk PE, 38.3% (n = 75) with intermediate-low-risk PE, and 22.5% (n = 44) with low-risk PE according to the European Society of Cardiology score. Mean plasma sP-selectin levels were comparable between survivors and non-survivors (489.7 ng/mL ±63 vs. 497.3 ng/mL ±51; p = .9). The ROC curve for 30-day all-cause mortality and major bleeding yielded an AUC of 0.49 (95% CI 0.36-0.63) and 0.46 (95% CI 0.24-0.68), respectively. Multivariate and survival analyses were precluded due to lack of significance. CONCLUSIONS sP-selectin was not useful for predicting short-term mortality or major bleeding in patients with acute symptomatic pulmonary embolism. Further studies are required to clarify the role of sP-selectin in VTE, particularly in prognosticating PE outcomes.
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Affiliation(s)
- Crhistian-Mario Oblitas
- Venous Thromboembolism Unit. Internal Medicine Department, General University Hospital Gregorio Marañón, Madrid, Spain
- School of Medicine, University Complutense of Madrid, Madrid, Spain
- Lipids and Cardiovascular Risk Unit, Sanitary Research Institute Gregorio Marañón, Madrid, Spain
| | - Pablo Demelo-Rodríguez
- Venous Thromboembolism Unit. Internal Medicine Department, General University Hospital Gregorio Marañón, Madrid, Spain
- School of Medicine, University Complutense of Madrid, Madrid, Spain
- Lipids and Cardiovascular Risk Unit, Sanitary Research Institute Gregorio Marañón, Madrid, Spain
| | - Marina López-Rubio
- Venous Thromboembolism Unit. Internal Medicine Department, General University Hospital Gregorio Marañón, Madrid, Spain
- School of Medicine, University Complutense of Madrid, Madrid, Spain
- Lipids and Cardiovascular Risk Unit, Sanitary Research Institute Gregorio Marañón, Madrid, Spain
| | - Marta-Olimpia Lago-Rodríguez
- Venous Thromboembolism Unit. Internal Medicine Department, General University Hospital Gregorio Marañón, Madrid, Spain
- School of Medicine, University Complutense of Madrid, Madrid, Spain
- Lipids and Cardiovascular Risk Unit, Sanitary Research Institute Gregorio Marañón, Madrid, Spain
| | - Mercedes García-Gámiz
- Department of Clinical Biochemistry, General University Hospital Gregorio Marañón, Madrid, Spain
| | - Angielys Zamora-Trillo
- Department of Clinical Biochemistry, General University Hospital Gregorio Marañón, Madrid, Spain
| | - Luis-Antonio Alvarez-Sala Walther
- Venous Thromboembolism Unit. Internal Medicine Department, General University Hospital Gregorio Marañón, Madrid, Spain
- School of Medicine, University Complutense of Madrid, Madrid, Spain
- Lipids and Cardiovascular Risk Unit, Sanitary Research Institute Gregorio Marañón, Madrid, Spain
| | - Rita García-Martínez
- Venous Thromboembolism Unit. Internal Medicine Department, General University Hospital Gregorio Marañón, Madrid, Spain
- School of Medicine, University Complutense of Madrid, Madrid, Spain
| | - Francisco Galeano-Valle
- Venous Thromboembolism Unit. Internal Medicine Department, General University Hospital Gregorio Marañón, Madrid, Spain
- School of Medicine, University Complutense of Madrid, Madrid, Spain
- Lipids and Cardiovascular Risk Unit, Sanitary Research Institute Gregorio Marañón, Madrid, Spain
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Galeano-Valle F, Ordieres-Ortega L, Oblitas CM, del-Toro-Cervera J, Alvarez-Sala-Walther L, Demelo-Rodríguez P. Inflammatory Biomarkers in the Short-Term Prognosis of Venous Thromboembolism: A Narrative Review. Int J Mol Sci 2021; 22:ijms22052627. [PMID: 33807848 PMCID: PMC7961591 DOI: 10.3390/ijms22052627] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 02/24/2021] [Accepted: 03/02/2021] [Indexed: 02/07/2023] Open
Abstract
The relationship between inflammation and venous thrombosis is not well understood. An inflammatory response may be both the cause and consequence of venous thromboembolism (VTE). In fact, several risk factors of VTE modulate thrombosis through inflammatory markers. Acute pulmonary embolism (PE) is burdened by a remarkable mortality rate, up to 34% in severely ill patients presenting with hemodynamic instability. Initial mortality risk stratification is based on hemodynamic instability. Patients with a situation of hemodynamic stability require immediate further risk assessment based on clinical, imaging, and circulating biomarkers, as well as the presence of comorbidities. Some inflammatory biomarkers have shown potential usefulness in the risk stratification of patients with VTE, especially acute PE. C-reactive protein on admission is associated with 30-day mortality and bleeding in VTE patients. P-selectin is associated with right ventricle dysfunction in PE patients and might be associated with VTE recurrences and the extension of thrombosis. Tissue factor microparticles are associated with VTE recurrence in cancer-associated thrombosis. Other inflammatory biomarkers present scarce evidence (inflammatory cytokines, erythrocyte sedimentation rate, fibrinogen, leukocyte count). In this manuscript, we will review the prognostic role of different inflammatory biomarkers available both for clinical practice and research in VTE patients.
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Affiliation(s)
- Francisco Galeano-Valle
- Venous Thromboembolism Unit, Internal Medicine, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo, 46, 28007 Madrid, Spain; (L.O.-O.); (C.M.O.); (J.d.-T.-C.); (P.D.-R.)
- School of Medicine, Universidad Complutense de Madrid, Plaza de Ramón y Cajal, s/n, 28040 Madrid, Spain;
- Sanitary Research Institute Gregorio Marañón, Calle Doctor Esquerdo, 46, 28007 Madrid, Spain
- Correspondence: ; Tel.: +34-915-868-000
| | - Lucía Ordieres-Ortega
- Venous Thromboembolism Unit, Internal Medicine, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo, 46, 28007 Madrid, Spain; (L.O.-O.); (C.M.O.); (J.d.-T.-C.); (P.D.-R.)
- School of Medicine, Universidad Complutense de Madrid, Plaza de Ramón y Cajal, s/n, 28040 Madrid, Spain;
| | - Crhistian Mario Oblitas
- Venous Thromboembolism Unit, Internal Medicine, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo, 46, 28007 Madrid, Spain; (L.O.-O.); (C.M.O.); (J.d.-T.-C.); (P.D.-R.)
- School of Medicine, Universidad Complutense de Madrid, Plaza de Ramón y Cajal, s/n, 28040 Madrid, Spain;
- Sanitary Research Institute Gregorio Marañón, Calle Doctor Esquerdo, 46, 28007 Madrid, Spain
| | - Jorge del-Toro-Cervera
- Venous Thromboembolism Unit, Internal Medicine, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo, 46, 28007 Madrid, Spain; (L.O.-O.); (C.M.O.); (J.d.-T.-C.); (P.D.-R.)
- School of Medicine, Universidad Complutense de Madrid, Plaza de Ramón y Cajal, s/n, 28040 Madrid, Spain;
- Sanitary Research Institute Gregorio Marañón, Calle Doctor Esquerdo, 46, 28007 Madrid, Spain
| | - Luis Alvarez-Sala-Walther
- School of Medicine, Universidad Complutense de Madrid, Plaza de Ramón y Cajal, s/n, 28040 Madrid, Spain;
- Sanitary Research Institute Gregorio Marañón, Calle Doctor Esquerdo, 46, 28007 Madrid, Spain
- Internal Medicine, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo, 46, 28007 Madrid, Spain
| | - Pablo Demelo-Rodríguez
- Venous Thromboembolism Unit, Internal Medicine, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo, 46, 28007 Madrid, Spain; (L.O.-O.); (C.M.O.); (J.d.-T.-C.); (P.D.-R.)
- School of Medicine, Universidad Complutense de Madrid, Plaza de Ramón y Cajal, s/n, 28040 Madrid, Spain;
- Sanitary Research Institute Gregorio Marañón, Calle Doctor Esquerdo, 46, 28007 Madrid, Spain
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Zhou X, Lin X, Shen R, Qu Y, Mo C, Li Y, Chen Q, Wu G, Chen Z, Huang K. A retrospective analysis of risk factors associated with catheter-related thrombosis: a single-center study. Perfusion 2020; 35:806-813. [PMID: 32419612 DOI: 10.1177/0267659120915142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Catheter-related thrombosis may lead to catheter infections and failure, further deep venous thrombosis, and pulmonary embolism. Recognizing the risk factors for catheter-related thrombosis is extremely important to inform the development of catheter care guidelines. METHODS Data were collected from a total of 1,532 patients who had undergone venous catheterization, including indwelling catheterization from 19 March 2019 to 30 March 2019 in the Sun Yat-sen Memorial Hospital. The factors for which data were to be collected included the patients' physical characteristics, catheter-related factors, and catheter care-related factors. Logistic regression analysis, the chi-squared test, Fisher's exact test, and the t-test were used to analyze the data. RESULTS Of the 1,532 patients studied, 28 developed intraductal thrombi, and of the factors analyzed, malignancy, a catheterization history, a history of thrombophilia, surgery during the week before catheterization, the catheterization duration, and anticoagulant therapy were significant risk factors associated with catheter-related thrombosis (all p < 0.05). There were no significant associations between the catheter brand, the number of lumens, the insertion direction, or the factors associated with catheter care and catheter-related thrombosis (all p > 0.05). CONCLUSION Our study incorporated clear and systematic risk factors associated with catheter-related thrombosis. Malignancy, history of thrombophilia, history of catheterization, surgery during the week before catheterization, and catheterization duration were associated with increased risks of catheter-related thrombosis. Prophylactic anticoagulation was effective for preventing and treating catheter-related thrombosis.
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Affiliation(s)
- Xuezhen Zhou
- Department of Nursing, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xi Lin
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Runnan Shen
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Yingying Qu
- Venous Catheter Nursing Clinic, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chunling Mo
- Venous Catheter Nursing Clinic, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yan Li
- Venous Catheter Nursing Clinic, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qinchang Chen
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.,The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Guitao Wu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Zhenhong Chen
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Kai Huang
- Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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