Plasma levels of P-selectin and future risk of incident venous thromboembolism.

Samantha Swamy, Thor Ueland, John-Bjarne Hansen, Omri Snir, Sigrid K Brækkan

Journal of thrombosis and haemostasis : JTH 2023 Sep

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P-selectin levels are elevated following acute deep vein thrombosis and reported to predict recurrent venous thromboembolism (VTE) and cancer-associated VTE. Yet, it is unknown whether plasma P-selectin levels are associated with incident VTE. We aimed to investigate the association between plasma P-selectin levels and risk of future incident VTE. We performed a nested case-control study in 415 patients with VTE and 843 age- and sex-matched controls derived from the general population (Tromsø IV Study). Plasma P-selectin levels were measured using enzyme-linked immunosorbent assay. Logistic regression models were used to estimate odds ratios (ORs) for VTE across quartiles of plasma P-selectin level. Sex-stratified analysis was also performed. Plasma P-selectin levels were higher in men (41.4 ng/mL) than in women (38.7 ng/mL, p = .0046). We found no association between plasma P-selectin levels and risk of VTE in the overall analyses. However, sex-stratified analyses revealed that women with P-selectin levels in the highest quartile (>44.3 ng/mL) had higher risk of VTE (OR, 1.63; 95% CI, 1.01-2.64) than women with P-selectin levels in the lowest quartile (≤29.9 ng/mL). In contrast, higher levels of P-selectin were apparently associated with lower risk of VTE in men (OR for highest vs lowest quartile of P-selectin, 0.69; 95% CI, 0.42-1.15). The observed associations were stronger when the time between blood sampling and VTE was shorter. Elevated levels of plasma P-selectin were associated with increased risk of VTE in women but not in men, suggesting a differential impact of sex on the association between P-selectin and VTE risk. Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

Citation

Samantha Swamy, Thor Ueland, John-Bjarne Hansen, Omri Snir, Sigrid K Brækkan. Plasma levels of P-selectin and future risk of incident venous thromboembolism. Journal of thrombosis and haemostasis : JTH. 2023 Sep;21(9):2451-2460