P-selectin levels are elevated following acute deep vein thrombosis (DVT) and reported to predict recurrent venous thromboembolism (VTE) and cancer-associated VTE. Yet, it is unknown whether plasma P-selectin levels are associated with incident VTE.
Investigate the association between plasma P-selectin levels and risk of future incident VTE.
We performed a nested case-control study in 415 VTE patients and 843 age- and sex-matched controls derived from the general population (Tromsø IV Study). Plasma P-selectin levels were measured by ELISA. Logistic regression models were used to estimate odds ratios (OR) for VTE across quartiles of plasma P-selectin level. Sex-stratified analysis was also performed.
Plasma P-selectin levels were higher in men (41.4 ng/mL) than women (38.7 ng/mL, p = 0.0046). We found no association between plasma P-selectin levels and risk of VTE in the overall analyses. However, sex-stratified analyses revealed that women with P-selectin levels in the highest quartile (>44.3 ng/mL) had higher risk of VTE (OR 1.63, 95% CI: 1.01-2.64) compared with women with P-selectin levels in the lowest quartile (≤29.9 ng/mL). In contrast, higher levels of P-selectin were apparently associated with lower risk of VTE in men (OR for highest vs. lowest quartile of P-selectin: 0.69, 95% CI: 0.42-1.15). The observed associations were stronger when the time between blood sampling and VTE was shorter.
Elevated levels of plasma P-selectin were associated with increased risk of VTE in women, but not in men, suggesting a differential impact of sex for the association between P-selectin and VTE risk.

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