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

Abstract

The relationship between inflammation and venous thrombosis is not well understood. An inflammatory response may be both the cause and consequence of venous thromboembolism (VTE). In fact, several risk factors of VTE modulate thrombosis through inflammatory markers. Acute pulmonary embolism (PE) is burdened by a remarkable mortality rate, up to 34% in severely ill patients presenting with hemodynamic instability. Initial mortality risk stratification is based on hemodynamic instability. Patients with a situation of hemodynamic stability require immediate further risk assessment based on clinical, imaging, and circulating biomarkers, as well as the presence of comorbidities. Some inflammatory biomarkers have shown potential usefulness in the risk stratification of patients with VTE, especially acute PE. C-reactive protein on admission is associated with 30-day mortality and bleeding in VTE patients. P-selectin is associated with right ventricle dysfunction in PE patients and might be associated with VTE recurrences and the extension of thrombosis. Tissue factor microparticles are associated with VTE recurrence in cancer-associated thrombosis. Other inflammatory biomarkers present scarce evidence (inflammatory cytokines, erythrocyte sedimentation rate, fibrinogen, leukocyte count). In this manuscript, we will review the prognostic role of different inflammatory biomarkers available both for clinical practice and research in VTE patients.

Liquid Biopsy and Potential Liquid Biopsy-Based Biomarkers in Philadelphia-Negative Classical Myeloproliferative Neoplasms: A Systematic Review

“…Moreover, PMPs seem to confer protection against the action of chemotherapy, particularly in acute myeloid leukemia, as reported by Cacic et al (2021) [ 53 ]. In addition, in malignant diseases, there is a link between TF+MPs and the recurrence of VTE [ 54 ]. Furthermore, RMPs and EMPs have been regarded as putative agents in the development of coronary heart disease and vascular events, e.g., acute myocardial infarction, whereas GMPs and other WBCs-derived MPs interact with immune cells and enhance the production of pro-inflammatory cytokines, participating in the pathogenesis and evolution of cardiovascular and allergic disorders, infections, pre-eclampsia or cancer [ 55 , 56 ].…”

Assessment and Mitigation of Bleeding Risk in Atrial Fibrillation and Venous Thromboembolism: Executive Summary of a European and Asia-Pacific Expert Consensus Paper

“…48 Blood (e.g., eGFR) and urine (e.g., proteinuria) based biomarkers of renal dysfunction have been used to improve clinical risk stratification for bleeding (as well as stroke) in AF. 49 50 In patients with VTE on OAC, information on biomarkers and bleeding risk is sparse, 51 and scores including biomarkers such as hemoglobin and/or creatinine (or creatinine clearance) have modest predictive performance. 52 53…”

The predictive value of systemic immune inflammation index on long-term outcomes among acute pulmonary embolism patients

“…An increase in the release of pro-coagulant and proinflammatory substances originating from endothelial cells, leukocytes, and platelets was observed in the clinical course of APE (20). Platelet activation and neutrophilic recruitment resulting from the acute inflammatory response were associated with unfavorable prognosis and mortality in APE patients (21).…”