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Tavares IR, Caffaro RA, Portugal MF, Ribeiro CM, da Silva VS, Krupa E, Nikolovski S, de Britto KF, Gomes Pereira Petisco AC, Miranda MC, Gomes de Souza Santos S, da Silva Dourado M, Siqueira PV, Siddiqui F, Fareed J, Ramacciotti E. Biomarkers Profile in Provoked Versus Unprovoked Deep Venous Thrombosis. Clin Appl Thromb Hemost 2024; 30:10760296241238211. [PMID: 38566607 PMCID: PMC10989034 DOI: 10.1177/10760296241238211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/12/2024] [Accepted: 02/23/2024] [Indexed: 04/04/2024] Open
Abstract
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.
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Affiliation(s)
- Isabela Rodrigues Tavares
- 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
| | - Roberto Augusto Caffaro
- Department of Vascular Surgery, Santa Casa de São Paulo School of Medical Sciences, São Paulo, SP, Brazil
| | | | | | | | - Emily Krupa
- Pathology Department, Hemostasis & Thrombosis Research Laboratories at Loyola University Medical Center, Maywood, IL, USA
| | - Srdjan Nikolovski
- Pathology Department, Hemostasis & Thrombosis Research Laboratories at Loyola University Medical Center, Maywood, IL, USA
| | - Karen Falcão de Britto
- Department of Vascular Surgery, Santa Casa de São Paulo School of Medical Sciences, São Paulo, SP, Brazil
| | | | | | | | | | | | - Fakiha Siddiqui
- Pathology Department, Hemostasis & Thrombosis Research Laboratories at Loyola University Medical Center, Maywood, IL, USA
- Program in Health Sciences. UCAM - Universidad Católica San Antonio de Murcia, Guadalupe, Murcia, Spain
| | - Jawed Fareed
- Pathology Department, Hemostasis & Thrombosis Research Laboratories at Loyola University Medical Center, Maywood, IL, USA
| | - Eduardo Ramacciotti
- Science Valley Research Institute, Santo André, São Paulo, Brazil
- Pathology Department, Hemostasis & Thrombosis Research Laboratories at Loyola University Medical Center, Maywood, IL, USA
- Department of Cardiovascular Medicine, Hospital e Maternidade Christóvão da Gama, Grupo DASA, Santo André, São Paulo, Brazil
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Grill MH, Caffaro RA, Grill TA, Júnior VC, Kikuchi R, Ribeiro CM, da Silva VS, Tafur AJ, Caprini JA, Ramacciotti E. A Prospective Study Evaluating Patterns of Responses to the Caprini Score to Prevent Venous Thromboembolism After Interventional Treatment for Varicose Veins. Clin Appl Thromb Hemost 2022; 28:10760296221112081. [PMID: 35850592 PMCID: PMC9309759 DOI: 10.1177/10760296221112081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Venous thromboembolism (VTE) is a critical complication of varicose vein
treatments. The Caprini Score (CS) is an established tool to assess
patients’ VTE risks. One disadvantage is the number of questions required,
some of them referring to a low incidence of disease, even lower in patients
seeking an elective procedure. These elements take time and may result in
filling errors if the CS is not filled out by a properly trained health
professional. Objective To establish a response pattern in CS, with emphasis on questions that
usually have a negative answer and propose a simpler adaptative digital
version without changing the original structure of the tool. Methods two hundred and twenty-seven patients in the pre-surgical treatment of
varicose veins were enrolled prospectively and submitted to the CS
evaluation. Results The pattern of dichotomous responses could be divided arbitrarily into four
subgroups considering the percentage of positive responses: none (11 items),
less than 3% (13 items), between 3% and 20% (5 items), and more than 20% (8
items). Of the 12 CS questions related to illnesses that occurred in the
last month, ten had had no responses, and 2 were less than 3%. Conclusion There is a pattern in the CS responses of patients with an indication of
surgical treatment of varicose veins. Many of the CS questions are not
helpful in this scenario and may result in filling errors performed by
untrained providers. An adaptative version of the CS might benefit varicose
veins surgery VTE risk stratification
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Affiliation(s)
| | | | | | | | - Roberto Kikuchi
- Santa Casa de São Paulo School of Medical Science, São Paulo, Brazil
| | | | | | - Alfonso J Tafur
- 3271NorthShore University Health System, Evanston, Illinois, USA
| | - Joseph A Caprini
- 3271NorthShore University Health System, Evanston, Illinois, USA
| | - Eduardo Ramacciotti
- Santa Casa de São Paulo School of Medical Science, São Paulo, Brazil.,600818Science Valley Research Institute, São Paulo, Brazil.,23356Hemostasis & Thrombosis Research Laboratories at Loyola University Medical Center, Maywood, IL, USA
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