Journal of thrombosis and haemostasis : JTH · 2025
Plasma proteomics does not identify biomarkers of venous thromboembolism recurrence during and after anticoagulation: results from the VISTA study.
СтатьяМногоцентровое исследованиеРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Smit Eva R, Poolen Geke C, van Duijl Tirsa T, Cannegieter Suzanne C, Muñoz Sandoval Diana, van der Zwaan Carmen, Geersing Geert-Jan, Hoogendijk Arie J, Schutgens Roger E G, Urbanus Rolf T, van den Biggelaar Maartje
Аннотация
BACKGROUND: Venous thromboembolism (VTE) is typically treated with anticoagulation for 3 to 6 months. Decisions about extending treatment require balancing recurrence and bleeding risk. Current prediction models based on clinical markers lack sufficient discriminative accuracy, emphasizing the need for reliable biomarkers.
OBJECTIVES: To identify plasma biomarkers associated with VTE recurrence during and after anticoagulation.
METHODS: We conducted a case-cohort study using data and samples from the VISTA trial, which followed patients with a first VTE who were treated with vitamin K antagonists (VKAs) for 6 months. Follow-up for recurrence was 2 years. Recurrence cases (N = 96) were compared with a randomly selected subcohort (n = 192). Plasma was collected in the final month of VKA therapy and 1 month after cessation. Unbiased mass spectrometry-based proteomics was used to analyze plasma proteins.
RESULTS: Principal component analysis revealed no global proteomic differences between patients with and without recurrence. In addition, no statistically significant changes in plasma protein levels were associated with recurrence, neither during nor after treatment. While paired sampling demonstrated variability in interindividual responses upon initiation and cessation of VKA treatment, including VKA-dependent coagulation proteins (eg, prothrombin [factor {F}II], coagulation FVII, FXI, FX, vitamin K-dependent protein S, protein C, and protein Z), there were no statistically significant differences in protein-level alterations associated with recurrence.
CONCLUSION: While plasma proteomics captured anticoagulation effects, it did not reveal biomarkers predictive of VTE recurrence, underscoring the need for alternative approaches.
OBJECTIVES: To identify plasma biomarkers associated with VTE recurrence during and after anticoagulation.
METHODS: We conducted a case-cohort study using data and samples from the VISTA trial, which followed patients with a first VTE who were treated with vitamin K antagonists (VKAs) for 6 months. Follow-up for recurrence was 2 years. Recurrence cases (N = 96) were compared with a randomly selected subcohort (n = 192). Plasma was collected in the final month of VKA therapy and 1 month after cessation. Unbiased mass spectrometry-based proteomics was used to analyze plasma proteins.
RESULTS: Principal component analysis revealed no global proteomic differences between patients with and without recurrence. In addition, no statistically significant changes in plasma protein levels were associated with recurrence, neither during nor after treatment. While paired sampling demonstrated variability in interindividual responses upon initiation and cessation of VKA treatment, including VKA-dependent coagulation proteins (eg, prothrombin [factor {F}II], coagulation FVII, FXI, FX, vitamin K-dependent protein S, protein C, and protein Z), there were no statistically significant differences in protein-level alterations associated with recurrence.
CONCLUSION: While plasma proteomics captured anticoagulation effects, it did not reveal biomarkers predictive of VTE recurrence, underscoring the need for alternative approaches.