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Could VEGF-D level have a role in clinical risk scoring, estimation of thrombus burden, and treatment in acute pulmonary thromboembolism?
  • +4
  • Buğra Kerget,
  • Dursun Erol Afşin,
  • Alperen Aksakal,
  • Ferhan Kerget,
  • Seda Aşkın,
  • Elif Yilmazel Ucar,
  • Leyla Sağlam
Buğra Kerget
Ataturk Universitesi
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Dursun Erol Afşin
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Alperen Aksakal
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Ferhan Kerget
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Seda Aşkın
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Elif Yilmazel Ucar
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Leyla Sağlam
Ataturk Universitesi
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Abstract

Objective: Pulmonary embolism (PE) is usually a complication of deep vein thrombosis and is an important cause of mortality and morbidity. Vascular endothelial growth factor D (VEGF-D) is a secretory protein that plays a role in the remodeling of blood vessels and the lymphatic system. This study aimed to determine the relationship between VEGF-D level and clinical risk scoring in patients with PE. Methods: The study included 117 patients admitted for PE that were divided into 4 groups: high-risk patients (n=35), high-intermediate-risk patients (n=30), low-intermediate-risk patients (n=24), and low-risk patients (n=28). Plasma VEGF-D was measured from peripheral venous blood samples (5 cc) using a commercial enzyme-linked immunosorbent assay (ELISA) kit. Pulmonary Artery Obstruction Index (PAOI) was calculated from CT angiography imaging. Results: VEGF-D levels in the low-risk PE group differed significantly from those in the high-intermediate and high-risk groups (p=0.001 for both) but not from that in the low-intermediate-risk PE group (p=0.155). There was no significant difference in troponin-I and NT-proBNP levels between the high-intermediate-risk and high-risk PE patients, whereas VEGF-D levels differed significantly (p=0.134, p=0.146, p=0.016). VEGF-D level was moderately correlated with mean pulmonary artery pressure and PAOI (r=0.481, p=0.01; r=0.404, p=0.01). In ROC curve analysis, a cut-off of 370.1 pg/ml for VEGF-D had 91.4% sensitivity and 67.4% specificity in the differentiation of high-intermediate-risk and high-risk PE patients. Conclusion: This study showed that plasma VEGF-D level was more reliable than troponin-I and NT-proBNP in clinical risk scoring and demonstrating thrombus burden. VEGF-D can be used as a biomarker in clinical risk scoring and estimation of thrombus burden in patients with acute PE.

Peer review status:IN REVISION

02 May 2021Submitted to International Journal of Clinical Practice
04 May 2021Assigned to Editor
04 May 2021Submission Checks Completed
05 May 2021Reviewer(s) Assigned
01 Jun 2021Review(s) Completed, Editorial Evaluation Pending
06 Jun 2021Editorial Decision: Revise Minor