Increased soluble P‐selectin levels following deep venous thrombosis: cause or effect?

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Abstract
Deep vein thrombosis (DVT) is associated with coagulation abnormalities, but evidence of excess platelet activity is scant. Soluble P‐selectin is a marker of platelet activity, with high levels being found in patients with thrombotic disease. We measured soluble P‐selectin by enzyme‐linked immunosorbent assay (ELISA) in plasma from 89 patients with objectively confirmed DVT and in 126 healthy age‐ and sex‐matched control subjects, and found higher levels in the patients (P = 0.011). Taking the risk of DVT with a level of soluble P‐selectin < 238 ng/ml to be 1, the relative risk of DVT with a soluble P‐selectin level >238 ng/ml was 2.1 (95% CI 1.2–3.6). These high levels may be a reflection of a generalized hypercoagulable state that, with factors such as the presence of persistent thrombin generation, could be responsible for excess platelet activation.