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 courseand 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). PlasmaHIF-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 therapyand those treated with enoxaparin sodium showed that HIF-1α levels were significantly higher in the group that received thrombolytictherapy (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 earlyindicator in intermediate high-risk PE, for which early reperfusion therapy is important.