Two Sides of the Coin: EPAS-1 as a Potential D-Dimer Alternative in Pulmonary Embolism Evaluation

The aim of this study was to determine changes in endothelial PAS domain protein-1 (EPAS-1) levels, a biomarker proven to increase with hypoxia, at the time of diagnosis and after treatment in addition to laboratory parameters and scoring systems examined at the time of admission in patients with pulmonary thromboembolism.

The study included 60 pulmonary embolism (PE) patients followed at the Cardiology clinic and 60 control participants with similar demographic characteristics. Laboratory parameters determined at the time of admission were examined. PE risk and severity scores were calculated, and EPAS-1 levels were also measured. To determine the response, EPAS-1 levels were checked 3 days later and compared with the control group.

There were no differences between the two groups in terms of demographic characteristics and comorbidities. EPAS-1 levels were higher at the time of diagnosis compared to the control group [(3.6 ± 1.42/1.57 ± 0.45), p < 0.001]. EPAS-1 levels were significantly positively correlated with pulmonary embolism severity index (PESI) severity score and risk score in the patient group. EPAS-1 levels decreased after treatment in the patients, and the tendency to decrease was different according to the types of treatment. In the patients who died, EPAS-1 levels continued to increase despite treatment (p = 0.014).

Our study is important in that EPAS-1 levels were correlated with scoring systems and other laboratory parameters used in PE patients, and that it can be used as a predictor in the diagnosis of the disease and play a complementary role in the evaluation of treatment response.