Investigation of human angptl4 (angiopoietin-like 4) levels in patients diagnosed with pulmonary thromboembolism

Pulmonary thromboembolism is one of the challenging diseases to diagnose and clinically suspect. Due to the inadequacy of scoring systems and diagnostic parameters, pulmonary thromboembolism remains a condition that can be overlooked and can have a fatal course. Patients often present to emergency services with non-specific symptoms such as shortness of breath, chest pain, syncope, and hemoptysis, making the clinician's experience and suspicion of the disease crucial. Given its high mortality rate, it is essential to quickly diagnose and initiate treatment in patients suspected of having pulmonary thromboembolism. Currently, there is no specific biomarker with high diagnostic accuracy. Therefore, we aimed to investigate the diagnostic utility and value of angiopoietin-like protein 4, a biomarker known to play a role in inflammation, in pulmonary thromboembolism. Our study was conducted prospectively and as a single-center study in the emergency department of a university hospital. The study included 41 patients with pulmonary thromboembolism and 41 healthy controls without pulmonary thromboembolism. Statistical significance was set at p < 0.05. Among the 82 individuals included in the study, 40 were male and 42 were female. The mean age (SD) of the patients was 62.4 (10.8) years, while the mean age (SD) of the control group was 61.0 (8.7) years. No significant difference was found between the groups in terms of age and gender. The mean angiopoietin-like protein 4 level in the control group was 12.1 ng/ml, while in the patient group, this value was 74.6 ng/ml. This difference was found to be statistically significant (p < 0.005). Using a cutoff value of 34.1 ng/ml for angiopoietin-like protein 4, the sensitivity for distinguishing between the patient and control groups was calculated to be 95.12%, and specificity was 90.24%. Based on these results, we believe that angiopoietin-like protein 4 levels could be used as a diagnostic marker in patients with pulmonary thromboembolism. However, this study is preliminary, and detailed research with larger sample sizes could provide more definitive information and new biomarkers in this area.