Department of Vascular Surgery, Santa Casa de São Paulo School of Medical Sciences, São Paulo, SP, Brazil.
Dante Pazzanese Cardiology Institute, São Paulo, SP, Brazil.
Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241238211. doi: 10.1177/10760296241238211.
Venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), represents a substantial healthcare challenge. Provoked and unprovoked DVT cases carry distinct risks and treatment considerations. Recognizing the limitations of this classification, molecular markers may enhance diagnostic precision and guide anticoagulation therapy duration relying on patient history and risk factors. This preliminary, open-label, prospective cohort study was conducted including 15 patients (10 provoked DVT and 5 unprovoked DVT) and a control group of healthy plasmatic subjects. Plasma levels of 9 biomarkers were measured at diagnosis (baseline, day 0, and D0) and after 30 days (day 30-D30). Patient demographics, clinical data, and biomarker concentrations were analyzed. Serum concentrations of D-dimer, von Willebrand factor, C-reactive protein, and Anti-Xa were elevated in DVT groups at D0 compared to controls. No significant differences were observed between the provoked and unprovoked groups on the day of diagnosis and 30 days later. Over 30 days, the provoked group exhibited significant biomarker changes related to temporal assessment. No significant differences were noted in the biomarker profile between provoked and unprovoked DVT groups. This study is indicative of the concept of individualized thrombosis assessment and subsequent treatment for VTE. Larger cohorts are warranted to validate these findings and further define the most appropriate use of the molecular markers.
静脉血栓栓塞症(VTE),包括深静脉血栓形成(DVT)和肺栓塞(PE),是一个重大的医疗保健挑战。诱发和非诱发 DVT 病例具有不同的风险和治疗考虑因素。认识到这种分类的局限性,分子标志物可以提高诊断的准确性,并根据患者的病史和风险因素指导抗凝治疗的持续时间。本初步、开放标签、前瞻性队列研究纳入了 15 名患者(10 例诱发性 DVT 和 5 例非诱发性 DVT)和健康血浆对照组。在诊断时(基线、第 0 天和 D0)和 30 天后(第 30 天-D30)测量了 9 种生物标志物的血浆水平。分析了患者的人口统计学、临床数据和生物标志物浓度。与对照组相比,DVT 组在 D0 时的血清 D-二聚体、血管性血友病因子、C 反应蛋白和抗 Xa 浓度升高。在诊断当天和 30 天后,诱发组和非诱发组之间没有观察到显著差异。在 30 天内,诱发组的生物标志物变化与时间评估相关,具有显著意义。在诱发和非诱发 DVT 组之间,生物标志物谱没有显著差异。这项研究表明了个体化血栓形成评估和随后治疗 VTE 的概念。需要更大的队列来验证这些发现,并进一步确定分子标志物的最佳用途。