Venous thromboembolism research priorities: A scientific statement from the American Heart Association and the International Society on Thrombosis and Haemostasis

Abstract

Venous thromboembolism (VTE) is a major cause of morbidity and mortality. The impact of the Surgeon General's Call to Action in 2008 has been lower than expected given the public health impact of this disease. This scientific statement highlights future research priorities in VTE, developed by experts and a crowdsourcing survey across 16 scientific organizations. At the fundamental research level (T0), researchers need to identify pathobiologic causative mechanisms for the 50% of patients with unprovoked VTE and better understand mechanisms that differentiate hemostasis from thrombosis. At the human level (T1), new methods for diagnosing, treating, and preventing VTE will allow tailoring of diagnostic and therapeutic approaches to individuals. At the patient level (T2), research efforts are required to understand how foundational evidence impacts care of patients (eg, biomarkers). New treatments, such as catheter-based therapies, require further testing to identify which patients are most likely to experience benefit. At the practice level (T3), translating evidence into practice remains challenging. Areas of overuse and underuse will require evidence-based tools to improve care delivery. At the community and population level (T4), public awareness campaigns need thorough impact assessment. Large population-based cohort studies can elucidate the biologic and environmental underpinings of VTE and its complications. To achieve these goals, funding agencies and training

Basic science research opportunities in thrombosis and hemostasis: Communication from the SSC of the ISTH

“…51 A recent report from the American Heart Association and the ISTH highlights the future research priorities in VTE. 1 VTE increases exponentially with age [52][53][54][55] and is dramatically elevated in individuals over 55 years. 56 VTE is also associated with several disease states, with active cancer accounting for approximately 20% of the overall incidence of VTE.…”

“…As a first step, the ISTH collaborated with the American Heart Association to develop a joint statement focused on venous thromboembolism. 1 The ISTH would then follow up with a roadmap that would incorporate hemorrhagic, thrombotic, and platelet disorders to cover the entire field. The Scientific and Standardization Committee (SSC) of the ISTH was identified as the ideal body to create a new SSC task force to develop the ISTH roadmap.…”

“…Hemostasis is a vital physiological mechanism that has two distinct but simultaneously occurring functions: (1) to stop the bleeding when disruption of the vessel integrity occurs; this process involves formation of hemostatic plugs comprised of platelets and fibrin; and…”

Is Hematopoietic Clonality of Indetermined Potential a Risk Factor for Pulmonary Embolism?

“… 2 Recently, guidelines recommend the maintenance of a long-term anticoagulant treatment in idiopathic VTE. 3 4 5 However, iPE is an heterogeneous state and characterization of new risk factors is mandatory to identify patients needing a long term treatment to avoid reccurence. Numerous scores have already been proposed to predict the individual risk of recurrence 2 3 4 but there is still a need to decipher better pathophysiological mechanisms involved in iPE, as highlighted recently by the American Heart Association and the International Society of Thrombosis and Haemostasis.…”

“…Numerous scores have already been proposed to predict the individual risk of recurrence 2 3 4 but there is still a need to decipher better pathophysiological mechanisms involved in iPE, as highlighted recently by the American Heart Association and the International Society of Thrombosis and Haemostasis. 5 …”