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CC BY 4.0 · Semin Thromb Hemost
DOI: 10.1055/a-2574-8775
Original Article

Hemostatic and Inflammatory Biomarkers are Associated with Functional Limitations after Venous Thromboembolism: A Prospective Cohort Study

Daniel Steiner
1   Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
,
Stephan Nopp
1   Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
,
Timothy Hoberstorfer
1   Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
,
Oliver Schlager
2   Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria
,
Ingrid Pabinger
1   Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
,
Benedikt Weber
3   Department of Dermatology, Medical University of Vienna, Vienna, Austria
,
Cihan Ay
1   Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
› Author Affiliations Funding The study was funded by the GTH Early Career Research Grant 2023.
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Abstract

Functional limitations often persist in patients with venous thromboembolism (VTE). The relevance of biomarkers for these outcomes remains unexplored. Therefore, we aimed to investigate the association of hemostatic, inflammatory, and cardiovascular biomarkers with functional limitations 3 months after VTE. We conducted a prospective cohort study, including patients with acute VTE within 21 days of diagnosis. Biomarker levels (D-dimer, fibrinogen, factor VIII [FVIII], von Willebrand factor antigen [VWF], C-reactive protein [CRP], troponin T, N-terminal pro-B-type natriuretic peptide [proBNP]) were measured at inclusion and 3 months. Functional limitations at 3 months were evaluated with the post-VTE functional status (PVFS) scale (0–4, higher indicating more limitations). The association of biomarkers with functional limitations was assessed with proportional odds models adjusted for confounders. Furthermore, we evaluated the area under the receiver operating characteristic curve (AUC-ROC) for the presence of slight-to-severe functional limitations. Overall, we included 290 patients (41.4% of women) with a median age of 54.9 years (interquartile range [IQR]: 43.1–64.2). D-dimer, fibrinogen, FVIII, VWF, and CRP measured at inclusion were independently associated with functional limitations at 3 months. VWF showed the most favorable AUC-ROC (0.62, 95% CI, 0.55–0.69). In patients with pulmonary embolism, troponin T and proBNP were not associated with functional limitations. At the 3-month follow-up, D-dimer was the only biomarker independently associated with functional limitations, yielding an area under the curve (AUC) of 0.62 (95% CI, 0.55–0.69). In conclusion, we identified biomarkers independently associated with functional limitations 3 months after VTE. Our results indicate a role of these biomarkers in the early identification of patients at risk of persistent functional limitations and suggest their involvement in the underlying mechanisms.

Keywords

biomarkers - deep vein thrombosis - functional status - pulmonary embolism - venous thromboembolism

Ethical Approval

The study was approved by the local Ethics Committee of the Medical University of Vienna (EK 1045/2020).


Authors' Contributions

S.N., I.P., and C.A. contributed to the study concept and design. D.S., S.N., T.H., B.W., and C.A. contributed to the acquisition of data. D.S. analyzed the data. All authors participated in the interpretation of data. D.S. drafted the first version of the manuscript. All authors critically revised the manuscript for important intellectual content and approved the final version for submission.


Data Availability Statement

Data will be shared upon reasonable request to the corresponding author.


Supplementary Material



Publication History

Received: 22 January 2025

Accepted: 24 March 2025

Accepted Manuscript online:
04 April 2025

Article published online:
25 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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