Venous thromboembolism (VTE) is a frequent complication in
cancer patients. Platelet activation is thought to be involved in
cancer-associated VTE. Here, we determined the association between evolving markers of platelet activation (soluble
P-selectin [sP-
selectin], soluble
CD40 ligand [sCD40L],
thrombospondin-1 [TSP-1] and
platelet factor-4 [PF-4]) and the development of
cancer-associated VTE. A nested matched case-control study was applied within a cohort of 1779 patients with different types of
cancer that had been included in the Vienna
Cancer and
Thrombosis Study (CATS), a prospective, observational study on patients with newly diagnosed or progressive
cancer after remission. Primary endpoint is symptomatic VTE during a maximum follow-up of 2 years. Cases (patients who developed VTE during follow-up) were matched in a 1:2 ratio to controls without VTE during follow-up with respect to
tumor type, stage and time of observation in the study. In total, 131 VTE cases were compared to 262 controls. In logistic regression analysis, only sP-
selectin was associated with risk of VTE. The odds ratios (OR) per double increase of sP-
selectin, sCD40L,
TSP-1 and PF-4 were 1.66 (95% confidence interval: 1.17-2.35, p = 0.005), 1.04 (0.89-1.21, p = 0.635), 1.09 (0.90-1.32, p = 0.360) and 1.03 (0.87-1.21, p = 0.737), respectively. In conclusion, sP-
selectin, but not sCD40L,
TSP-1 or PF-4 were associated with risk of VTE in
cancer patients in this nested case-control study.