P-selectin and persistent thrombosis in venous thromboembolism

Abstract

Background: P-selectin levels have been reported as a predictor of recurrent venous thromboembolism (VTE). However, the association between plasma P-selectin levels and persistent thrombus in VTE remains unclear. Objectives: This study aimed to investigate the relationship between plasma P-selectin levels and persistent thrombus in patients with VTE. Methods: We included 40 patients with a history of venous thrombosis, including deep vein thrombosis and pulmonary thromboembolism, at least three months after completing anticoagulant treatment. A control group of 40 individuals, matched for age and gender, with no history of thromboembolism, was also included. At the time of inclusion, control group participants had Creactive protein levels within the normal range and no history of diabetes mellitus or chronic kidney disease. Plasma P-selectin levels were measured using an enzyme-linked immunosorbent assay (ELISA). Logistic regression models were used to estimate odds ratios (ORs) for persistent thrombi based on plasma P-selectin levels. Results: Among the 40 patients, 26 (65%) had persistent thrombi, detected in either the lower limb veins or pulmonary arteries using Doppler ultrasound and angio-CT. Multivariable analysis identified elevated P-selectin levels (cutoff: 63.1 ng/mL, 75th percentile of the study population) as a statistically significant risk factor for VTE. The analyses further revealed that individuals with P-selectin levels in the highest quartile (>63.1 ng/mL) had a significantly higher likelihood of persistent thrombus (OR: 1.63; 95% CI: 1.01–2.64) compared to those in the lowest quartile (≤38.4 ng/mL). Conclusion: Elevated plasma P-selectin levels were associated with an increased risk of persistent thrombus in VTE. Further studies are needed to confirm these findings.