Download PDF
Thromb Haemost 2007; 97(06): 880-883
DOI: 10.1160/TH07-02-0115
Rapid and Short Communication
Schattauer GmbH

Circulating P-selectin and the risk of recurrent venous thromboembolism

Paul A. Kyrle
1   Department of Medicine I
,
Gregor Hron
1   Department of Medicine I
,
Sabine Eichinger
1   Department of Medicine I
,
Oswald Wagner
2   Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria
› Author Affiliations
Further Information

Publication History

Received 14 February 2007

Accepted after revision 03 April 2007

Publication Date:
27 November 2017 (online)

Also available at
    Permissions and Reprints

Summary

The clinical relevance of high P-selectin levels in venous thrombosis is unknown. We prospectively followed 544 patients with first unprovoked venous thromboembolism (VTE) after cessation of anticoagulation and evaluated P-selectin as a risk factor of recurrent VTE. VTE recurred in 63 (12%) patients. Patients with recurrence had significantly higher P-selectin levels than those without (45.8 mg/dl ± 16.4 vs. 40.1 mg/dl ± 13.3; p = 0.006). After four years, the probability of recurrence was 20.6% (95% confidence interval [CI] 12.6–28.5) among patients with P-selectin values above the 75th percentile of the patient population and was 10.8% (95% CI 7.2–14.3) among patients with lower values (p = 0.046). Compared to patients with low P-selectin, adjusted risk of recurrence was 1.7-fold (95% CI 1.0–2.9, p = 0.045) increased among patients with P-selectin levels exceeding the 75th percentile. We conclude that high circulating P-selectin is a risk factor of recurrent VTE.

Keywords

venous thromboembolism - P-selectin - recurrence - risk factor
 

  • References

  • 1 Polgar J, Matuskova J, Wagner DD. The P-selectin, tissue factor, coagulation triad. J Thromb Haemost 2005; 3: 1590-1596.
    CrossrefPubMedGoogle Scholar
  • 2 Vandendries ER, Furie BC, Furie B. Role of P-selectin and PSGL-1 in coagulation and thrombosis. Thromb Haemost 2004; 92: 459-466.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Palabrica T, Lobb R, Furie BC. et al. Leukocyte accumulation promoting fibrin deposition is mediated in vivo by P-selectin on adherent platelets. Nature 1992; 359: 848-851.
    CrossrefPubMedGoogle Scholar
  • 4 Sullivan VV, Hawley AE, Farris DM. et al. Decrease in fibrin content of venous thrombi in selectin-deficient mice. J Surg Res 2003; 109: 1-7.
    CrossrefPubMedGoogle Scholar
  • 5 Falati S, Liu Q, Gross P. et al. Accumulation of tissue factor into developing thrombi in vivo is dependent upon microparticle P-selectin glycoprotein ligand 1 and platelet P-selectin. J Exp Med 2003; 197: 1585-1598.
    CrossrefPubMedGoogle Scholar
  • 6 Andre P, Hartwell D, Hrachovinova I. et al. Pro-coagulant state resulting from high levels of soluble P-selectin in blood. Proc Natl Acad Sci USA 2000; 97: 13835-13840.
    CrossrefPubMedGoogle Scholar
  • 7 Myers Jr. DD, Hawley AE, Farris DM. et al. P-selectin and leukocyte microparticles are associated with venous thrombogenesis. J Vasc Surg 2003; 38: 1075-1089.
    CrossrefPubMedGoogle Scholar
  • 8 Hrachovinova I, Cambien B, Hafezi-Moghadam A. et al. Interaction of P-selectin and PSGL-1 generates microparticles that correct hemostasis in a mouse model of hemophilia A. Nat Med 2003; 9: 1020-1025.
    CrossrefPubMedGoogle Scholar
  • 9 Ikeda H, Takajo Y, Ichiki K. et al. Increased soluble form of P-selectin in patients with unstable angina. Circulation 1995; 92: 1693-1696.
    CrossrefPubMedGoogle Scholar
  • 10 Tsakiris DA, Tschopl M, Jager K. et al. Circulating cell adhesion molecules and endothelial markers before and after transluminal angioplasty in peripheral arterial occlusive disease. Atherosclerosis 1999; 142: 193-200.
    CrossrefPubMedGoogle Scholar
  • 11 Ikeda H, Nakayama H, Oda T. et al. Soluble form of P-selectin in patients with acute myocardial infarction. Coron Artery Dis 1994; 5: 515-518.
    PubMedGoogle Scholar
  • 12 Ridker PM, Buring JE, Rifai N. Soluble P-selectin and the risk of future cardiovascular events. Circulation 2001; 103: 491-495.
    CrossrefPubMedGoogle Scholar
  • 13 Hillis GS, Terregino C, Taggart P. et al. Elevated soluble P-selectin levels are associated with an increased risk of early adverse events in patients with presumed myocardial ischemia. Am Heart J 2002; 143: 235-241.
    CrossrefPubMedGoogle Scholar
  • 14 Kyrle PA, Minar E, Bialonczyk C. et al. The risk of recurrent venous thromboembolism in men and women. N Engl J Med 2004; 350: 2558-2563.
    CrossrefPubMedGoogle Scholar
  • 15 Kalbfleisch JD, Prentice RL. The statistical analysis of failure time data. John Wiley & Sons; 1980
    Google Scholar
  • 16 Cambien B, Wagner DD. A new role in hemostasis for the adhesion receptor P-selectin. Trends Mol Med 2004; 10: 179-186.
    CrossrefPubMedGoogle Scholar
  • 17 Hathcock JJ, Nemerson Y. Platelet deposition inhibits tissue factor activity: in vitro clots are impermeable to factor Xa. Blood 2004; 104: 123-127.
    CrossrefPubMedGoogle Scholar
  • 18 Weitz JI. Emerging anticoagulants for the treatment of venous thromboembolism. Thromb Haemost 2006; 96: 274-284.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Myers DD, Rectenwald JE, Bedard PW. et al. Decreased venous thrombosis with an oral inhibitor of P selectin. J Vasc Surg 2005; 42: 329-336.
    CrossrefPubMedGoogle Scholar
  • 20 Myres DD, Henke PK, Bedard PW. et al. Treatment with an oral small molecule inhibitor of P selectin (PSI-697) decreases vein wall injury in a rat stenosis model of venous thrombosis. J Vasc Surg 2006; 44: 625-632.
    CrossrefPubMedGoogle Scholar