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. 2017 Aug 1;10(8):8786-8794.
eCollection 2017.

Plasma follistatin-like protein 1 is correlated with disease severity in patients with acute pulmonary embolism and predicts short-term mortality

Ruomin Liao  1 , Zeyong Yang  2 , Yanan Yin  3 , Xiaoyuan Sun  1 , Fengming Ding  1
Affiliations

Plasma follistatin-like protein 1 is correlated with disease severity in patients with acute pulmonary embolism and predicts short-term mortality

Ruomin Liao et al. Int J Clin Exp Pathol. .

Abstract

We investigated the plasma levels of follistatin-like protein 1 (FSTL1) in patients with acute pulmonary embolism (PE) and whether it could predict short-term mortality. A prospective observational cohort study was conducted in patients with acute PE (n = 220). FSTL1 was measured in plasma samples using enzyme-linked immunosorbent assay. Plasma FSTL1 levels were significantly increased in patients with acute PE, and positively correlated with disease severity (rs = 0.7171). Sensitivity and specificity rates for high-risk PE at a specific FSTL1 cutoff point (23 ng/ml) were 79.3% and 92.9%. Multivariant Cox regression analysis showed that FSTL1 was independently associated with 30-day mortality rate. Addition of FSTL1 to the PE severity index (PESI) scoring system significantly improved the predictive value for 30-day mortality. These results indicate that the plasma level of FSTL1 is correlated with disease severity in patients with acute PE and predicts short-term mortality.

Keywords: Pulmonary embolism; biomarker; disease severity; follistatin-like protein 1; mortality.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Plasma FSTL1 concentrations in patients with different risk levels at the time of diagnosis (A). The correlation between FSTL1 and disease severity at diagnosis was calculated using spearman correlation coefficient (B). Whiskers of the boxplot mark the 5th and 95th percentiles, the box 25th percentile, median and 75th percentile. PE: Pulmonary embolism; FSTL1: Follistatin-like protein 1.
Figure 2
Figure 2
Correlation of serum FSTL1 levels with D-dimer, cTnI, BNP and patient PESI score in acute PE population. Correlation coefficients (rs) from the Spearman rank-order test are displayed. Each point represents an individual value. FSTL1: Follistatin-like protein 1; BNP: Brain natriuretic peptide; cTnI: Cardiac troponin I; PESI: Pulmonary embolism severity index; PE: Pulmonary embolism.
Figure 3
Figure 3
Receiver operator curve analysis for FSTL1 levels at no-high-risk PE and high-risk PE. The area under the curve was 0.8968 (95% CI, 0.8302-0.9634). The sensitivity rate of 79.3% and specificity rate of 92.9% corresponded to 23 ng/ml. FSTL1: Follistatin-like protein 1; CI: Confidence interval.
Figure 4
Figure 4
Kaplan Meier survival analysis according to FSTL1 levels. FSTL1: Follistatin-like protein 1.
Figure 5
Figure 5
Receiver operating characteristic curves for the 30-day mortality. The curves are based on logistic regression models for risk prediction, incorporating the following: Model 1, PESI (AUC = 0.8523; 95% CI, 0.7686-0.9360); Model 2, FSTL1 (AUC = 0.8682; 95% CI, 0.7502-0.9762); Model 3, PESI + FSTL1 (AUC = 0.9439; 95% CI, 0.9021-0.9806), P = 0.0006 versus Model 1, P = 0.0238 versus Model 2. PESI: Pulmonary embolism severity index; AUC: Area under the receiver operating characteristic curve; CI: Confidence interval; FSTL1: Follistatin-like protein 1.
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References

    1. Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galie N, Gibbs JS, Huisman MV, Humbert M, Kucher N, Lang I, Lankeit M, Lekakis J, Maack C, Mayer E, Meneveau N, Perrier A, Pruszczyk P, Rasmussen LH, Schindler TH, Svitil P, Vonk Noordegraaf A, Zamorano JL, Zompatori M. 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J. 2014;35:3033–3069. 3069a–3069k. - PubMed
    1. Ozlek E, Ozlek B, Biteker FS, Biteker M. Thrombolytic therapy in submassive pulmonary embolism. Indian Heart J. 2017;69:286. - PMC - PubMed
    1. Penaloza A, Roy PM, Kline J. Risk stratification and treatment strategy of pulmonary embolism. Curr Opin Crit Care. 2012;18:318–325. - PubMed
    1. Li D, Wang Y, Xu N, Wei Q, Wu M, Li X, Zheng P, Sun S, Jin Y, Zhang G, Liao R, Zhang P. Follistatin-like protein 1 is elevated in systemic autoimmune diseases and correlated with disease activity in patients with rheumatoid arthritis. Arthritis Res Ther. 2011;13:R17. - PMC - PubMed
    1. Gorelik M, Wilson DC, Cloonan YK, Shulman ST, Hirsch R. Plasma Follistatin-Like protein 1 is elevated in kawasaki disease and may predict coronary artery aneurysm formation. J Pediatr. 161:116–119. - PMC - PubMed

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