Novel Biomarkers in Deep Vein Thrombosis

Abstract

Venous thromboembolic disease (VTE) remains a significant source of morbidity and mortality. As non-specific subjective complaints and a paucity of objective clinical examination findings complicate the diagnosis of both deep venous thrombosis (DVT) and pulmonary embolism (PE), diagnostic modalities remain essential. Symptoms suggestive of deep vein thrombosis are extremely common in practice but unfortunately non-specific. The modified Wells score remains the most supported clinical decision rule for risk stratifying these concerns. Compression ultrasound remains the gold standard for diagnosis of DVT. Reliable imaging is not always available, so making a serologic diagnosis, or biomarker, is highly desirable. While D-dimer, a highly sensitive biomarker, is useful for excluding acute VTE, it lacks the specificity necessary for diagnostic confirmation. As such, ongoing research efforts target and support the utility of alternative plasma biomarkers to aid in the diagnosis of VTE including selectins, microparticles, IL-10, and other inflammatory markers. These molecular markers may also predict recurrence risk, guide length and modality of treatment, and predict which thrombi will resolve spontaneously or recanalize, thus potentially identifying patients who would benefit from more aggressive therapies than standard anticoagulation [1].