OC 25.4 - Thrombo-inflammatory biomarkers in pulmonary embolism as stratified in cancer and non-cancer patient groups.

Sunday, July 10, 2022

3:30 PM – 3:45 PM

Location: ExCel Center, ICC Capital Suite Room 8&9

Presentation Format: In-Person

Presenting Author(s)

Fakiha Siddiqui, PhD Candidate

PhD Candidate
Department of Pathology and Laboratory Medicine, Cardiovascular Research Institute, Loyola University Chicago, Health Sciences Division, Maywood, IL, USA.
Maywood, Illinois, United States

Co-Author(s)

AD

Amir Darki

Associate Professor
Department of Internal Medicine, Division of Cardiology, Loyola University Medical Center, 2160 S. 1st Avenue, Maywood, IL 60153, USA.
Maywood, Illinois, United States
DH

Debra Hoppensteadt

Professor
Loyola University Chicago
Maywood, Illinois, United States
ID

Iman Darwish

Medical Student
Loyola University Chicago, Stritch School of Medicine
Maywood, Illinois, United States
BK

Bulent Kantarcioglu

Senior Research Office
Department of Molecular Pharmacology & Neuroscience, Loyola University Medical Center, 2160 S. 1st Avenue, Maywood, IL 60153, USA.
Maywood, Illinois, United States
AT

Alfonso Tafur

Attending Physician, Senior Author
Northshore University HealthSystem, Cardiovascular Institute
Evanston, Illinois, United States
JF

Jawed Fareed, n/a

Professor
Loyola University Medical Center
MAYWOOD, Illinois, United States
MM

Manuel Monreal

MD PhD
Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol. Badalona, Barcelona, Spain Chair for the Study of Thromboembolic Disease, Faculty of Health Sciences, UCAM - Universidad Católica San Antonio de Murcia, Spain
Barcelona, Andalucia, Spain

Background: The multifactorial and complex pathophysiology of pulmonary embolism (PE) involves dysregulation of hemostatic system including fibrinolytic imbalance, endothelial compromise, and generation of thrombotic mediators, along with cellular defects and hemodynamic derangement. Cancer is prevalent in PE patients and is considered an added risk factor for the adverse outcomes. Thrombo-inflammatory biomarkers profiling provide means to risk stratify PE patients.

Aims: This study aimed to profile several of these biomarkers in normal and PE patients and to further demonstrate any potential difference between cancer and non-cancer patients.

Methods: Four hundred patients of 18 years or older age, were included through enrolment in conjunction with IRB approved project by the pulmonary embolism response team (PERT) registry. Diagnosis of PE was confirmed by computed tomography (CT), angiography or ventilation perfusion imaging. Blood samples were drawn with in 24 hours of confirmed diagnosis of acute PE. Control plasma samples were obtained from 50 healthy individuals. All plasma samples were analyzed for D-Dimer, PAI-1 antigen, tPA, TAFI-a, vWF, CRP and IL-6 were measured by ELISA methods. Microparticles were measured using a chromogenic functional method. Individual biomarkers were compared to normal plasma and further stratified into cancer and non-cancer.

Results: All the individual biomarkers exhibited varying levels of elevation in PE patients compare to normal’s (Table 1). D-Dimer and CRP showed the most pronounced increase. When the PE group stratified into cancer and non-cancer patients, most of the biomarkers except D-Dimer and microparticles showed varying degree of modest elevation in the cancer group (Table 2). vWF, IL6 and microparticles levels were found to be significantly different in the cancer group.

Conclusion(s): These studies demonstrate that thrombo-inflammatory biomarkers are upregulated in PE patients. Furthermore, PE patients with cancer exhibit amplified levels of some of the biomarkers suggesting the severity of pathogenesis involving thrombo-inflammatory mechanisms.