Abstract
The initial evaluation of patients with suspected deep vein thrombosis includes the use of biomarkers reflecting activation of the coagulation system. However, the thromboembolic process and neighboring inflammatory responses also affect endothelial cells, and endothelial cell markers may therefore be altered by the disease. In the present population-based single-center study, we investigated the plasma levels of the endothelium-specific biomarkers soluble E-selectin and endocan in a consecutive and unselected group of 120 patients admitted to hospital for suspected deep vein thrombosis. Blood samples were collected when patients arrived at the hospital. DVT patients showed evidence for an acute phase reaction with increased serum C-reactive protein levels, but this was similar to many other patients admitted with suspected but not verified thrombosis. Plasma endocan and E-selectin levels did not differ between patients with thrombosis, healthy controls and the patients without verified thrombosis (i.e. patients with other causes of their symptoms, including various inflammatory and non-inflammatory conditions). However, the combined use of endothelial biomarkers, C-reactive protein and D-dimer could be used to identify patient subsets with different frequencies of venous thrombosis. Thus, analysis of plasma biomarker profiles including endothelial cell markers may be helpful in the initial evaluation of patients with deep vein thrombosis.
Highlights
The development of venous thromboembolism (VTE), i.e. deep vein thrombosis (DVT) and pulmonary embolism (PE), represents a complex interaction between inflammatory pathways as well as the coagulation system, and it involves a wide range of cells including various leukocytes, platelets and endothelial cells (Fox & Kahn 2005; Hou et al 2012; Coleman & Wakefield 2012)
The possible use of biomarker panels in the diagnosis of venous thromboembolic disease should probably follow a similar strategy, and the present study represents a first step in a similar process where we investigate the possible use of biologically relevant biomarkers in clinically relevant contrasting groups, i.e. patients with and without verified deep vein thrombosis in a group of unselected patients admitted to hospital with suspected thrombosis
DVT was diagnosed in a minority of patients admitted to hospital with suspected thrombosis The large majority of the patients were referred to the hospital due to recent development of pain localized to the leg, pain when palpating the leg and unilateral edema of the lower extremity
Summary
The development of venous thromboembolism (VTE), i.e. deep vein thrombosis (DVT) and pulmonary embolism (PE), represents a complex interaction between inflammatory pathways as well as the coagulation system, and it involves a wide range of cells including various leukocytes, platelets and endothelial cells (Fox & Kahn 2005; Hou et al 2012; Coleman & Wakefield 2012). A similar initial strategy was used to design a prognostic biomarker panel for patients with suspected severe sepsis, and these authors used a panel of 9 mediators in their final analysis (Shapiro et al 2009). The possible use of biomarker panels in the diagnosis of venous thromboembolic disease should probably follow a similar strategy, and the present study represents a first step in a similar process where we investigate the possible use of biologically relevant biomarkers (i.e. endothelial cell markers) in clinically relevant contrasting groups, i.e. patients with and without verified deep vein thrombosis in a group of unselected patients admitted to hospital with suspected thrombosis
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call