Could HIF-1α be a novel biomarker for the clinical course and treatment of pulmonary embolism?

Abstract

Background/aim: Pulmonary embolism (PE) is associated with high morbidity and mortality rates if not diagnosed and treated rapidly. The aim of our study was to investigate the relationship between levels of hypoxia-induced factor-1 alpha (HIF-1α) and clinical course and prognosis in patients with intermediate low-risk, intermediate high-risk, and high-risk PE. Materials and methods: The study included 240 subjects in 4 groups: a healthy control group (n = 60, mean age = 60 ± 15.2, female/male = 30/30), intermediate low-risk PE group (n = 60, mean age = 60 ± 12,5, female/male = 27/33), intermediate high-risk PE group (n = 60, mean age = 61,4 ± 14,8, female/male = 36/24), and high-risk PE group (n = 60, mean age = 62,3 ± 15, female/male = 33/27). Plasma HIF-1α levels were measured using commercial enzyme-linked immunosorbent assay (ELISA) kit. Results: Comparison of HIF-1α levels revealed a statistically significant difference between the groups in proportion to clinical scoring (P = 0.001 for all). Comparison of initial HIF-1α and troponin levels in intermediate high-risk PE patients given thrombolytic therapy and those treated with enoxaparin sodium showed that HIF-1α levels were significantly higher in the group that received thrombolytic therapy (P = 0.001), while there was no difference in troponin levels (P = 0.146). Conclusion: HIF-1α can be used in the PE clinical risk stratification and monitoring of PE and may also serve as a valuable early indicator in intermediate high-risk PE, for which early reperfusion therapy is important.

Could VEGF‐D level have a role in clinical risk scoring, estimation of thrombus burden, and treatment in acute pulmonary thromboembolism?

“…3 Right ventricular dilatation results in the release of certain cytokines to ensure oxygenation, neovascularization, and rapid thrombus organization. 4 The most important of these cytokines is vascular endothelial growth factor (VEGF). 5 VEGF causes endothelial proliferation and neovascularization, and prevents reperfusion injury by increasing glutathione peroxidase activity.…”

Hypoxia-inducible factor-1α is a biomarker for predicting patients with sepsis

“…Many studies have shown the application of HIF-1a in diagnosing diseases with tissue hypoxia. Kergert et al 20 found that HIF-1a plays a vital role as a biomarker in the early diagnosis and disease risk stratification of pulmonary embolism. Other studies have also…”

“…Kergert et al. 20 found that HIF-1α plays a vital role as a biomarker in the early diagnosis and disease risk stratification of pulmonary embolism. Other studies have also shown that HIF-1α may be a helpful indicator for the early diagnosis of acute decompensated heart failure or renal vascular diseases.…”

Investigation of the need for computed tomography pulmonary angiography in the decision to discontinue treatment for pulmonary thromboembolism

“…PTE is one of the major emergencies for which morbidity and mortality rates are declining due to advances in early diagnosis and treatment [8]. In treatment, the duration of secondary prophylaxis varies based on the risk factors present [9][10][11]. It was reported that 81% of 69 PTE patients followed up with CT angiography had complete resolution after 4 weeks [12].…”