Evaluation of soluble P‐selectin as a predictive biomarker in acute symptomatic pulmonary embolism: Insights from a prospective observational study.

Background: Soluble P‐selectin (sP‐selectin) has been proposed as a potential biomarker for venous thromboembolism (VTE) diagnosis with interesting results. However, its role in predicting early mortality in pulmonary embolism (PE) remains unexplored. Methods: This observational, prospective, single‐center study enrolled consecutive patients aged 18 or older with confirmed acute symptomatic PE and no prior anticoagulation. The study aims to assess the prognostic capacity of sP‐selectin measured at the time of PE diagnosis for short‐term mortality and major bleeding. Results: A total of 196 patients, with a mean age of 69.1 years (SD 17), were included, of whom 52.6% were male. Within 30 days, 9.7% of patients (n = 19) died, and 5.1% (n = 10) suffered major bleeding. PE risk stratification revealed 4.6% (n = 9) with high‐risk PE, 34.7% (n = 68) with intermediate‐high‐risk PE, 38.3% (n = 75) with intermediate‐low‐risk PE, and 22.5% (n = 44) with low‐risk PE according to the European Society of Cardiology score. Mean plasma sP‐selectin levels were comparable between survivors and non‐survivors (489.7 ng/mL ±63 vs. 497.3 ng/mL ±51; p =.9). The ROC curve for 30‐day all‐cause mortality and major bleeding yielded an AUC of 0.49 (95% CI 0.36–0.63) and 0.46 (95% CI 0.24–0.68), respectively. Multivariate and survival analyses were precluded due to lack of significance. Conclusions: sP‐selectin was not useful for predicting short‐term mortality or major bleeding in patients with acute symptomatic pulmonary embolism. Further studies are required to clarify the role of sP‐selectin in VTE, particularly in prognosticating PE outcomes. [ABSTRACT FROM AUTHOR]