The Role of Biomarkers, Metabolomics, and COVID-19 in Venous Thromboembolism—A Review of Literature
Abstract
:1. Introduction
2. COVID and Venous Thromboembolism
3. Biomarkers in Venous Thromboembolism
3.1. D-Dimer
3.2. Thrombin
3.3. P-Selectin
3.4. Inflammatory Cytokines
3.5. MPs (Microparticles)
4. Metabolomics
Analysis of Metabolites Involved
5. Treatment of Venous Thromboembolism
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- Proximity deep vein thrombosis (DVT) of the lower extremity;
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- Symptomatic distal DVT (calf vein);
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- Symptomatic upper extremity DVT (axillary-subclavian veins);
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- Pulmonary embolism (PE);
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- Subsegmental EP in a patient at risk of recurrence;
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- Surveillance for subsegmental EP in a patient without proximal DVT and a reduced risk of recurrence.
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- Low molecular weight heparin;
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- Fondaparinux;
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- Unfractionated heparin;
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- Oral anticoagulants directed against factor Xa or thrombin inhibitors.
- The initial phase (about 5–21 days after diagnosis): patients, depending on clinical features, receive either treatment initially parenterally and then switch to treatment with vitamin K antagonists (VKAs), or begin treatment with high-dose therapy [11]
- Long-term treatment: therapy with VKA or DOAC 3–6 months after diagnosis [11].
- -
- Prolonged treatment (after the initial 3–6 months): The decision to prolong treatment (beyond the first 3–6 months) is related to the benefit/risk ratio of continuing anticoagulant therapy and must be tailored on every single patient [97].
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- Thrombosis, usually employed in patients with acute thromboembolism and hemodynamic instability;
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- Vena cava filter in patients for whom anticoagulant therapy is absolutely contraindicated [97];
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- Elastic compression and rapid mobilization have also been found to be effective in the treatment of DVT—however, careful caution is needed in patients with severe peripheral arterial disease [97].
6. Conclusions
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Metabolite | Disease | Directionality and Context of the Changes |
---|---|---|
Hypoxanthine | DVT | Raised in jugular vein thrombus, compared to venous blood levels (in rabbit) |
Serotonin | DVT | Raised in jugular vein thrombus, compared to venous blood levels (in rabbit) |
Guanine | DVT | Raised in jugular vein thrombus, compared to venous blood levels (in rabbit) |
Taurine | DVT | Raised in jugular vein thrombus, compared to venous blood levels (in rabbit) |
AMP | DVT | Raised in jugular vein thrombus, compared to venous blood levels (in rabbit) |
3-Hydroxykynurenine | DVT | Raised in jugular vein thrombus, compared to venous blood levels (in rabbit) |
Lactic acid | DVT | Raised in jugular vein thrombus, compared to venous blood levels (in rabbit) |
Citric acid | DVT | Reduced in jugular vein thrombus, compared to venous blood levels (in rabbit) |
Glucose 6-phosphate | DVT | Reduced in jugular vein thrombus, compared to venous blood levels (in rabbit) |
NADP | DVT | Reduced in jugular vein thrombus, compared to venous blood levels (in rabbit) |
Tryptophan | DVT | Reduced in jugular vein thrombus, compared to venous blood levels (in rabbit) |
Methionine sulfoxide | DVT | Reduced in jugular vein thrombus, compared to venous blood levels (in rabbit) |
Cysteine glutathione disulfide | DVT | Reduced in jugular vein thrombus, compared to venous blood levels (in rabbit) |
Glutamine | DVT | Raised in whole blood samples of old mice with venous thrombosis (VT) of inferior vena cava, compared with young mice with VT and age-matched controls without VT |
Phenylalanine | DVT | Raised in whole blood samples of old mice with VT of inferior vena cava, compared with young mice with VT and age-matched controls without VT |
Proline | DVT | Raised in whole blood samples of old mice with VT of inferior vena cava, compared with young mice with VT and age-matched controls without VT |
Glycerol | PE | Raised in venous blood samples of pigs with PE compared to pigs without PE. |
Pyruvic acid | PE | Raised in venous blood samples of pigs with PE compared to pigs without PE. |
Lactic acid | PE | Raised in venous blood samples of pigs with PE compared to pigs without PE. |
Palmitic acid | PE | Raised in venous blood samples of pigs with PE compared to pigs without PE. |
Oleic acid | PE | Raised in venous blood samples of pigs with PE compared to pigs without PE. |
3-hydroxybutyric acid | PE | Raised in venous blood samples of pigs with PE compared to pigs without PE. |
10:1 Acylcarnitines | PE | Reduced in venous blood samples of patients who had PE 3 months before compared with patients without history of PE. |
16:1 Acylcarnitines | PE | Reduced in venous blood samples of patients who had PE 3 months before compared with patients without history of PE. |
Initial Phase VTE | Dosing | 5–21 Days after Diagnosis |
---|---|---|
APIXABAN | 10 mg bid | for the first 7 days |
RIVAROXABAN | 15 mg bid | for the first 21 days |
EDOXABAN | 60 mg/day or 30 mg/day with regard to actual functionality by low-molecular-weight heparin | for 5–10 days |
DABIGATRAN | 150 mg bid preceded by low-molecular-weight heparin | for the first 5–10 days |
Long-Term Treatment | Dosing | Days after Initial Phase |
APIXABAN | 5 mg bid/2.5 mg bid | for 3–6 months |
RIVAROXABAN | 20 mg die | for 3–6 months |
EDOXABAN | 60 mg/day or 30 mg/day with regard to actual functionality | for 3–6 months |
DABIGATRAN | 150 mg bid ore 110 mg die | for 3–6 months |
VKA | Dosing related INR value | for 3–6 months |
LOW-MOLECULAR-WEIGHT HEPARIN | Dosing is typically weight-based and continued at the same dose used for initial anticoagulation. | for 3–6 months |
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Della Corte, V.; Riolo, R.; Scaglione, S.; Pecoraro, R.; Tuttolomondo, A. The Role of Biomarkers, Metabolomics, and COVID-19 in Venous Thromboembolism—A Review of Literature. Int. J. Mol. Sci. 2023, 24, 13411. https://doi.org/10.3390/ijms241713411
Della Corte V, Riolo R, Scaglione S, Pecoraro R, Tuttolomondo A. The Role of Biomarkers, Metabolomics, and COVID-19 in Venous Thromboembolism—A Review of Literature. International Journal of Molecular Sciences. 2023; 24(17):13411. https://doi.org/10.3390/ijms241713411
Chicago/Turabian StyleDella Corte, Vittoriano, Renata Riolo, Stefania Scaglione, Rosaria Pecoraro, and Antonino Tuttolomondo. 2023. "The Role of Biomarkers, Metabolomics, and COVID-19 in Venous Thromboembolism—A Review of Literature" International Journal of Molecular Sciences 24, no. 17: 13411. https://doi.org/10.3390/ijms241713411