Abstract 17351: Elevated Plasma Levels of Soluble P-Selectin Predict Survival in Chronic Thromboembolic Pulmonary Hypertension
Introduction. The platelet activation marker P-selectin is critically involved in the pathogenesis of venous thrombosis. Chronic Thromboembolic Pulmonary Hypertension is thought to be a late sequelae of venous thrombosis with obstruction of pulmonary arteries by organized thrombus. Methods. Enzyme-linked immunoassay was used to determine soluble P-selectin plasma levels in patients with Chronic Thromboembolic Pulmonary Hypertension at the time of diagnosis. Analysis of overall survival was performed using Kaplan-Meier curves that were stratified by soluble P-selectin levels above and below median at baseline. Results. Soluble P-selectin plasma levels were studied in 212 patients of whom 100 patients (47%) were classified as operable and 112 patients (53%) as nonoperable due to imbalance between hemodynamics and extent of pulmonary arterial obstructions, or comorbidities. Soluble P-selectin plasma levels were 104 ng/ml (median;range(54-221)), with no difference between operable and nonoperable patients. During an observation time of 4.4 years (median; IQR: 2.2-5.9) 75 deaths of any cause occurred (Figure) and 4 patients underwent double lung transplantation. Patients with soluble P-selectin levels ≤104ng/ml (Figure - solid line) survived longer than those with levels >104ng/ml (Figure - dashed line; P<0.001). Conclusion. Soluble P-Selectin predicts survival in Chronic Thromboembolic Pulmonary Hypertension. The data suggest that platelet activation is involved in venous thrombosis.
- © 2012 by American Heart Association, Inc.