Soluble endothelial protein C receptor is an independent predictor of venous thromboembolism after severe injury: Secondary analysis of a prospective cohort study.
Soluble endothelial protein C receptor is an independent predictor of venous thromboembolism after severe injury: Secondary analysis of a prospective cohort study.
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DOI：
10.1016/j.surg.2023.04.049
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发表时间：
2023-08
期刊：
影响因子：
3.8
通讯作者：
Cardenas, Jessica C.
中科院分区：
文献类型：
--
作者：
Sanders, Kelly E.;Holevinski, Sarah;Zhang, Xu;Cotton, Bryan A.;Cardenas, Jessica C.
静脉血栓栓塞（VTE）是创伤后发病的主要原因。内皮细胞（EC）是凝血的重要调节者。虽然创伤后EC失调被广泛报道，但内皮损伤和VTE之间的联系尚未报道。我们对实用随机最佳血小板和血浆比率（PROPPR）研究进行了二次分析。出血或24小时内死亡被排除。通过双功超声或胸部计算机断层扫描诊断VTE。通过酶联免疫吸附试验测定血浆中的内皮标志物可溶性内皮蛋白C受体（sEPCR）、血栓调节蛋白（sTM）和多配体蛋白聚糖-1（Sdc 1），并使用Mann-Whitney检验比较入院后最初72小时内的情况。多变量logistic回归评估了内皮标志物对VTE风险的校正效应。在入组的575例患者中，86例发生了VTE（15%）。至VTE的中位时间为6天（（Q1，Q3），（4，13））。在人口统计学或损伤严重程度方面没有发现差异。与未发生VTE的患者相比，发生VTE的患者的sEPCR、sTM和Sdc 1随时间推移显著增加。使用最后可用值，将患者分层为高和低sEPCR、sTM和Sdc 1组。多变量分析显示sEPCR升高与VTE风险之间存在独立相关性[比值比1.63; 95% CI 1.01，2.63; p=0.04]。考克斯比例风险模型显示，sEPCR升高与至VTE时间之间存在强但不显著的趋势。内皮损伤的血浆标志物，特别是sEPCR与创伤相关性VTE密切相关。靶向内皮功能的治疗可以降低创伤后VTE的发生率。
Venous thromboembolism (VTE) is a leading cause of morbidity after trauma. Endothelial cells (ECs) are essential regulators of coagulation. While EC dysregulation is widely reported after trauma, the link between endothelial injury and VTE has not been reported. We conducted a secondary analysis of the Pragmatic Randomized Optimal Platelets and Plasma Ratios (PROPPR) study. Deaths from hemorrhage or within 24 hours were excluded. VTE was diagnosed by duplex ultrasound or chest computed tomography. Endothelial markers soluble endothelial protein c receptor (sEPCR), thrombomodulin (sTM), and syndecan-1 (Sdc1) were measured in plasma by enzyme-linked immunosorbent assay and compared over the first 72 hours from admission using Mann-Whitney test. Multivariable logistic regression assessed the adjusted effects of endothelial markers on VTE risk. Of 575 patients enrolled, 86 developed VTE (15%). Median time to VTE was 6 days ((Q1, Q3), (4, 13)). No differences were identified in demographics or injury severity. sEPCR, sTM, and Sdc1 showed significant increases over time among patients who developed VTE compared to those who did not. Using last available values, patients were stratified into high and low sEPCR, sTM, and Sdc1 groups. Multivariable analyses revealed an independent association between elevated sEPCR and VTE risk [Odds Ratio 1.63; 95% CI 1.01, 2.63; p=0.04]. Cox proportional hazards modeling demonstrated a strong yet non-significant trend between elevated sEPCR and time to VTE. Plasma markers of endothelial injury, in particular sEPCR are strongly associated with trauma-related VTE. Therapeutics targeting endothelial function could mitigate the incidence of VTE following trauma.
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影响因子：
3.1
作者：
Dillon, Gabrielle A.;Stanhewicz, Anna E.;Serviente, Corinna;Flores, Valerie A.;Stachenfeld, Nina;Alexander, Lacy M.
通讯作者：
Alexander, Lacy M.
从内皮细胞的角度来看血栓形成的调节
DOI：
10.1161/atvbaha.118.310367
发表时间：
2018-06
期刊：
Arteriosclerosis, thrombosis, and vascular biology
影响因子：
--
作者：
Wang M;Hao H;Leeper NJ;Zhu L;Early Career Committee
通讯作者：
Early Career Committee
影响因子：
2.1
作者：
Yau JW;Teoh H;Verma S
通讯作者：
Verma S
影响因子：
20.3
作者：
Campbell, Robert A.;Overmyer, Katherine A.;Wolberg, Alisa S.
通讯作者：
Wolberg, Alisa S.
影响因子：
24
作者：
Chirinos, JA;Heresi, GA;Ahn, YS
通讯作者：
Ahn, YS