Soluble P-Selectin for the Diagnosis of Lower Extremity Deep Venous Thrombosis

Vandy, Frank C.; Stabler, Cathy; Hawley, Angela E.; Ballard-Lipka, N.; Guire, Kenneth E.; Baker, Nicole; Myers, Daniel D.; Rectenwald, John E.; Henke, Peter K.; Wakefield, Thomas W.

doi:10.1016/j.jvs.2011.11.031

Cited by 3 publications

(3 citation statements)

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“…Furthermore, P-selectin levels seem to be both a risk factor for DVT at least in cancer patients [15,29] and a possible diagnostic tool in the handling of patients with suspected DVT [25]. However, a recent larger study concluded that P-selectin adds little to the diagnostic value of D-dimer alone [30]. This last conclusion is supported by our present observations; P-selectin gives the best discriminative value for DVT among the biomarkers investigated in our present study, but none of our biomarkers seem to be better than D-dimer.…”

Section: Discussionmentioning

confidence: 99%

Altered plasma levels of cytokines, soluble adhesion molecules and matrix metalloproteases in venous thrombosis

Mosevoll

Lindås

Tvedt

et al. 2015

Thrombosis Research

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Section: Discussionmentioning

confidence: 99%

Altered plasma levels of cytokines, soluble adhesion molecules and matrix metalloproteases in venous thrombosis

Mosevoll

Lindås

Tvedt

et al. 2015

Thrombosis Research

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“…This patient population was part of the “Michigan DVT Study” (12). Patient demographics and clinical characteristics were recorded, including the Wells score along with all clinical risk factors associated with DVT.…”

Section: Methodsmentioning

confidence: 99%

Plasma DNA is elevated in patients with deep vein thrombosis

Díaz

Fuchs

Jackson

et al. 2013

Journal of Vascular Surgery: Venous and Lymphatic Disorders

107

110

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Objective To investigate if plasma DNA is elevated in patients with deep vein thrombosis (DVT) and to determine whether there is a correlation with other biomarkers of DVT. Background Leukocytes release DNA to form extracellular traps (ETs), which have recently been linked to experimental DVT. In baboons and mice, extracellular DNA co-localized with von Willebrand factor (VWF) in the thrombus and DNA appeared in circulation at the time of thrombus formation. ETs have not been associated with clinical DVT. Setting From December 2008 to August 2010, patients were screened through the University of Michigan Diagnostic Vascular Unit and were divided into three distinct groups: 1) the DVT positive group, consisting of patients who were symptomatic for DVT, which was confirmed by compression duplex ultrasound (n=47); 2) the DVT negative group, consisting of patients that present with swelling and leg pain but had a negative compression duplex ultrasound, (n=28); and 3) a control group of healthy non-pregnant volunteers without signs or symptoms of active or previous DVT (n=19). Patients were excluded if they were less than 18 years of age, unwillingness to consent, pregnant, on an anticoagulant therapy, or diagnosed with isolated calf vein thrombosis. Methods Blood was collected for circulating DNA, CRP, D-dimer, VWF activity, myeloperoxidase (MPO), ADAMTS13 and VWF. The Wells score for a patient’s risk of DVT was assessed. The Receiver Operating Characteristic (ROC) curve was generated to determine the strength of the relationship between circulating DNA levels and the presence of DVT. A Spearman correlation was performed to determine the relationship between the DNA levels and the biomarkers and the Wells score. Additionally the ratio of ADAMTS13/VWF was assessed. Results Our results showed that circulating DNA (a surrogate marker for NETs) was significantly elevated in DVT patients, compared to both DVT negative patients (57.7±6.3 vs. 17.9±3.5ng/mL, P<.01) and controls (57.7±6.3 vs. 23.9±2.1ng/mL, P<.01). There was a strong positive correlation with CRP (P<.01), D-dimer (P<.01), VWF (P<.01), Wells score (P<.01) and myeloperoxidase (MPO) (P<.01), along with a strong negative correlation with ADAMTS13 (P<.01) and the ADAMTS13/VWF ratio. The logistic regression model showed a strong association between plasma DNA and the presence of DVT (ROC curve was determined to be 0.814). Conclusions Plasma DNA is elevated in patients with deep vein thrombosis and correlates with biomarkers of DVT. A strong correlation between circulating DNA and MPO suggests that neutrophils may be a source of plasma DNA in patients with DVT.

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“…As such, a sP-sel level greater than 90 ng/ml combined with a Wells' score 2 or greater was found to be as effective as duplex ultrasound at ruling in the diagnosis of DVT, while a sP-sel level less than 60 ng/ml with a Wells' score less than 2 was able to effectively 'rule-out' the diagnosis (Table 1). A similar study from the same institution performed to improve the statistical validity of the aforementioned findings used a different validation cohort to analyze the role of sP-sel in the diagnosis DVT [21]. One hundred and fifty-nine patients were analyzed including 80 patients with confirmed DVT and 79 controls.…”

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confidence: 99%