Diagnostic and prognostic importance of EPAS-1 in acute pulmonary embolism

Objective: Our aim in this study is to reveal the changes in EPAS-1 levels, a biomarker proven to increase with hypoxia, at the time of diagnosis and after treatment, in addition to the laboratory parameters and scoring systems examined at the time of admission in patients with pulmonary thromboembolism. Materials and Methods: Our study included 60 diagnosed pulmonary embolism patients who were followed up in the Cardiology clinic and 60 control groups with similar demographic characteristics who were examined in the Cardiology outpatient clinic and did not have pulmonary embolism. Laboratory parameters determined at the time of admission were examined, and electrocardiographic and echocardiographic measurements were recorded. Additionally, pulmonary embolism risk and severity scores were applied and EPAS-1 levels were studied. To determine the treatment response, EPAS-1 levels were checked after 3 days and compared with the control group. Results: There was no difference between the two groups in terms of demographic characteristics, hypertension, diabetes mellitus, coronary artery disease and lung disease. EPAS-1 levels were found to be higher at the time of diagnosis compared to the control group ((3.6±1.42/1.57±0,45), p<0.001). It showed a statistically significant positive correlation with PESI severity score and risk score in the patient group. It was shown that EPAS-1 levels decreased with the treatments of the patients and their tendency to decrease was different depending on the treatment types. It was shown that EPAS-1 levels continued to increase in patients who died despite treatment (p:0.014). Conclusion: There is currently no biomarker that can be used as a diagnostic or exclusion criterion in patients with pulmonary thromboembolism. EPAS-1 levels were found to be increased in pulmonary embolism patients at the time of diagnosis, and were shown to decrease after the success of medical treatment. Our study is important in that EPAS-1 levels, which are significant and correlated with scoring systems and other laboratory parameters used in pulmonary embolism patients, can be used as a predictive value in the diagnosis process of the disease and play a complementary role in the evaluation of treatment response.