Skip to main content
ISTH 2024 Main banner
Back

Poster Networking

Venous Thromboembolism

PB0366 - The importance of circulating activated protein C, neutrophil extracellular trap markers, and thrombin generation test in predicting thrombotic events

Sunday, June 23, 2024
13:45 – 14:45 ICT
Room: Exhibition Hall

    Presenting Author(s)

  • JO

    Julia Oto

    Postdoctoral researcher
    Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe
    Valencia, Comunidad Valenciana, Spain

    • Co-Author(s)

  • LM

    Laura Martos

    Researcher
    Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe
    Valencia, Comunidad Valenciana, Spain

  • F

    Álvaro Fernández-Pardo

    Postdoctoral researcher
    Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe
    Valencia, Comunidad Valenciana, Spain

  • EP

    Emma Plana

    Postdoctoral Researcher
    Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe
    Valencia, Comunidad Valenciana, Spain

  • DH

    David Hervás

    Postdoctoral researcher
    Biostatistics Unit, Medical Research Institute Hospital La Fe
    Valencia, Comunidad Valenciana, Spain

  • FC

    Fernando Cana

    Laboratory technician
    Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe
    Valencia, Comunidad Valenciana, Spain

  • RH

    Raquel Herranz

    PhD candidate
    Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe
    Valencia, Comunidad Valenciana, Spain

  • PV

    Patricia Verger

    Researcher
    Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe
    Valencia, Comunidad Valenciana, Spain

  • SB

    Santiago Bonanad

    Head of Thrombosis and Hemostasis Unit
    Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe
    Valencia, Comunidad Valenciana, Spain

  • FF

    Fernando Ferrando

    Medical doctor
    Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe
    Valencia, Comunidad Valenciana, Spain

  • SN

    Silvia Navarro

    Postdoctoral researcher
    Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe
    Valencia, Comunidad Valenciana, Spain

  • Pilar Medina, PhD

    Principal Investigator
    Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Health Research Institute Hospital La Fe
    Valencia, Comunidad Valenciana, Spain

Background: VTE is a complex disease with multiple risk factors, making it challenging to predict. Despite extensive research, no single biomarker combination accurately predicts thrombotic risk.

Aims: We aim to evaluate the predictive value of circulating activated protein C (APC), neutrophil extracellular trap (NET) markers, and thrombin generation test (TGT) for thrombotic events, based on our previous findings of altered levels in patients with VTE or cancer-associated thrombosis.

Methods: We obtained citrated plasma from 113 VTE patients 3-12 months after the event and under no treatment, and from 183 healthy controls. In all of them, we quantified APC with an assay developed by our group, various NETs markers (circulating free DNA, cfDNA; DNA-histone complexes, myeloperoxidase and calprotectin) and performed the TGT using an automated test (CAT, Thrombinoscope). Using values from 83 randomly relected patients and 157 controls, we generated a multivariable logistic regression model to predict VTE with R (v3.5.0), and validated it in 30 patients and 26 independent controls.

Results: Compared with controls, VTE patients showed decreased APC levels (P < 0.01), and increased cfDNA, myeloperoxidase and calprotectin (P < 0.01 in all cases) and thrombin generation (P < 0.05). We obtained a VTE predictive model with APC, cfDNA, calprotectin, TGT peak and lagtime, with an area under the ROC curve (AUC) of 0.93 (95% CI: 0.85-1). When we validated our model in an independent cohort of subjects, we obtained a validated AUC of 0.96 (95% CI: 0.911-1), with the model being able to correctly classify 87% of the patients and 88% of the controls.

Conclusion(s): We have developed a predictive model for VTE using plasma biomarkers. This model could be useful for predicting thrombotic events in high-risk patients, reinforcing current clinical variables. ISCIII-FEDER (PI20/00075, FI21/00171, PI23/00449) and SETH.