From Classical Laboratory Parameters to Novel Biomarkers for the Diagnosis of Venous Thrombosis

Abstract

Venous thrombosis is a common and potentially fatal disease, because of its high morbidity and mortality, especially in hospitalized patients. To establish the diagnosis of venous thrombosis, in the last years, a multi-modality approach that involves not only imaging modalities but also serology has been evolving. Multiple studies have demonstrated the use of some biomarkers, such as D-dimer, selectins, microparticles or inflammatory cytokines, for the diagnosis and treatment of venous thrombosis, but there is no single biomarker available to exclusively confirm the diagnosis of venous thrombosis. Considering the fact that there are some issues surrounding the management of patients with venous thrombosis and the duration of treatment, recent studies support the idea that these biomarkers may help guide the length of appropriate anticoagulation treatment, by identifying patients at high risk of recurrence. At the same time, biomarkers may help predict thrombus evolution, potentially identifying patients that would benefit from more aggressive therapies. This review focuses on classic and novel biomarkers currently under investigation, discussing their diagnostic performance and potential benefit in guiding the therapy for venous thrombosis.

Triglyceride-Rich Lipoproteins and Their Remnants as Silent Promoters of Atherosclerotic Cardiovascular Disease and Other Metabolic Disorders: A Review

“…Of note, decreased concentration of adiponectin and enhanced generation of plasma thrombin independently increase CVD risk [ 62 ]. Thrombin, by favoring clot formation, is linked to an increased risk of thromboembolic events [ 63 ].…”

Inflammatory Biomarkers in the Short-Term Prognosis of Venous Thromboembolism: A Narrative Review

“…Considering that there is a poor standardization of analytical methods for MP detection [ 76 ], there is a discrepancy between the results of different studies. Many of them, including a recent meta-analysis [ 77 ], linked elevated levels of MP with the future occurrence of thrombosis, whereas others did not demonstrate its role as a predictive biomarker [ 78 ] or showed heterogeneous results. An association with the occurrence of VTE in pancreatic cancer might be present, whereas in other cancer entities, this could not be confirmed [ 75 , 79 ].…”

“…Several studies emphasize the role of inflammatory markers such as interleukin (IL)-1, 6, 8, and 10 in VTE. By influencing the expression of TF, inflammatory cytokines provide a trigger that may lead to thrombotic disease [ 78 ]. Genetic association studies have reported possible links between inflammation-related genetic variants, especially cytokines (e.g., IL-1, IL-4, IL-10) [ 81 ] and VTE, thus establishing a role of genetic background in predisposition to VTE and variable inflammatory processes in individuals.…”

“…However, IL-10 has been described as a protective factor for VTE [ 85 ], and mutations in the IL-10 allele have been reported as an independent risk factor for VTE and recurrent VTE [ 78 , 86 ]. Elmoamly et al [ 71 ] investigated TNF-α and IL-6, among other biomarkers.…”

Multiple Facets of Venous Thrombosis

“…Finally, search for specific biomarkers is necessary for both verification of the diagnosis and, importantly, prediction of the probability of thrombosis. A review by Anghel et al in this issue Journal presents a set of previously known as well as novel biomarkers of venous thrombosis and discusses their potential benefits and limitations in diagnosis and building the treatments strategy for DVT [ 3 ].…”