Higher soluble P-selectin is associated with chronic venous insufficiency: The San Diego Population Study

Introduction: P-selectin is a cell adhesion molecule shown to play a role in venous thromboembolism. We evaluated whether higher P-selectin is associated with chronic venous insufficiency (CVI). Materials and Methods: In a cohort of 2408 participants, the San Diego Population Study, peripheral venous disease was established by symptoms, clinical examination, and ultrasound. We measured P-selectin in a subsample of 352 CVI cases frequency matched to controls. Cases included four hierarchical groups of increasing severity of CVI. Results: The association of P-selectin with CVI considering all cases was weak, with an age, race and sex-adjusted odds ratio (OR) of 1.3 (95% CI 1.0-2.2) for values in the 3rd versus 1st tertile. The OR for cases in the two most severe groups was 2.3 (95% CI 1.2-4.2). Addition of body mass index to the model reduced this OR to 1.9 (95% CI 1.0-3.6). Conclusions: Higher circulating P-selectin was associated with more severe CVI, but not CVI overall. Results support that platelet and endothelial cell activation may be involved in the pathogenesis of CVI.