Serum CD-31 (s-PECAM 1) level in patients with acute pulmonary thromboembolism

Objective: Pulmonary thromboembolism (PTE) is currently the most common cause of cardiovascular mortality, with an increasing incidence and decreasing mortality rate. It typically occurs as a complication of deep vein thrombosis (DVT). In pulmonary thromboembolism (PTE), a series of pathophysiological events are triggered by the formation of a blood clot in the lungs. Vasoconstriction caused by inflammatory mediators, serotonin released from platelets, thromboxane, and fibropeptide B, a product of fibrinogen degradation, influence the pathophysiological events and clinical findings in PTE. The platelet endothelial cell adhesion molecule (PECAM-1) is a protein encoded by the PECAM1 gene located on chromosome 17q23.3 in humans. PECAM-1 is present on the surface of platelets, monocytes, neutrophils, and some T cells, and is a critical component of endothelial cell intercellular junctions. The characteristics of the CD-31(sPECAM-1) antigen suggest that it plays a role in the interactions involved in angiogenesis, thrombosis, and wound healing, which are essential processes in tumor growth and metastasis.The objective of this study was to explore the correlation between clinical findings and serum CD-31 (sPECAM-1) levels in patients diagnosed with PTE, as well as the efficacy of these biochemical markers in diagnosing the disease and assessing its severity. Materials and Methods: In our study, 119 patients who applied to the pulmonology outpatient clinic between Dec 01.03.2024 - Dec 05.03.2025 and were consulted to the pulmonology clinic and acute pulmonary thromboembolism (PTE) was detected by computed tomography pulmonary angiography (BTPA) were examined. The inclusion and exclusion criteria of the patient group studied before comparing the basic demographic characteristics of the patients, routine biochemical examinations, and serum CD-31 levels were determined as stated below. Inclusion criteria for the study: 1. Being over 18 years old 2. Diagnosis of acute PTE with computed tomography pulmonary angiography 3. Volunteering in the study Exclusion criteria; 1.Being under the age of 18 2. Presence of malignancy 3.Presence of hereditary thrombophilia 4. Chronic hematological disease 5. Those with a history of coronary artery bypass surgery (CABG) and other cardiac interventions 6. Pregnancy 7. Diagnosis of diabetes mellitus 8. Not wanting to participate in the study In our study, 87 patients met the inclusion criteria and serum CD-31(sPECAM-1) levels were studied and the serum CD-31(sPECAM-1) levels of healthy volunteer patients in the same age range were compared. The healthy control group was formed from people who did not have any chronic diseases, but who applied to the hospital for routine control and no disease was detected. Serum CD-31(PECAM-1) levels were studied by ELISA method. Results were analyzed using SPSS statistical software (version 25.0; IBM, Armonk, NY, USA). Results: In this study, 177 patients were included. There were 87 volunteers with acute PTE (45.2% female, 52.7% male) and 90 healthy control patients (54.8% female, 47.3% male). The study evaluated these groups separately. The Mann-Whitney U test was used for the correlation analysis to compare high CD-31 (s-PECAM-1) levels between the pulmonary embolism patient group and the control group. A statistically significant difference was found in the CD-31 (s-PECAM-1) levels between the pulmonary embolism patient group and the control group. Z = -11,377; p ≤0,001. In our study, the serum CD-31(s-PECAM 1) level was also examined for the effect of serum CD-31(s-PECAM 1) level on the prognosis of the disease, the presence of pulmonary embolism in the main pulmonary artery, the serum CD-31(s-PECAM 1) level in patients who needed thrombolytic therapy with unilateral or bilateral localization, and the Mann-Whitney U test was performed to compare the serum CD-31(s-PECAM 1) level of all these groups. A statistically significant difference was found at the CD-31(s-PECAM 1) level in the absence or presence of the main pulmonary artery (Z = -2.103; p=0.035. A statistically significant difference was found in the serum CD-31(s-PECAM 1) level in those with unilateral and bilateral embolism (Z = -2.130; p=0.033.) A statistically significant difference was found in the CD-31(s-PECAM 1) level between those who needed thrombolytic therapy and those who did not. (Z = -3.812; p ≤0.001.) Discussion: In our study, we found that levels of CD-31 were significantly higher in patients with pulmonary embolism compared to the control group. CD-31 levels were also significantly higher in a subgroup of pulmonary embolism patients that we evaluated. There is only one study in the literature that investigates the relationship between CD-31 (sPECAM-1) levels and pulmonary embolism. In that study, serum CD-31 (sPECAM-1) levels were compared between patients with type 2 diabetes mellitus who developed pulmonary embolism and those who did not. The study found that CD-31 (sPECAM-1) levels were higher in the group that developed pulmonary embolism. However, this study was conducted with a very small number of patients. Conclusions: This study aimed to determine the levels of CD-31 (sPECAM-1) in the blood of patients with thromboembolism and to contribute to the existing literature. This previously unexplored topic has significant potential for future research. Keywords: CD-31(sPECAM-1), Pulmonary Tromboembolis, Deep Vein Thrombosis