Venous Thromboembolism (VTE) Clinical Trial
Official title:
Evaluation of the Predictive Value of the Microvesicle Coagulo-lytic Balance in the Recurrence of Venous Thrombosis
Venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE)
affects about 1,200,000 individuals each year in Europe. About 50% of VTE are unprovoked and
20% of these patients will face a recurrent event after the usual three to six‐month course
of anticoagulant treatment. To date, most patients are given prolonged anticoagulant
treatment. However, anticoagulant treatment are associated with a major risk of bleeding
(3%/year). Thus an accurate identification of patients with unprovoked VTE with a low risk of
recurrence is needed to avoid unnecessary anticoagulant treatment with a risk of bleeding.
Over the past few years, microparticles (MPs) which are small vesicles originating from the
budding of cellular membranes have emerged as important biological entities regulating
hemostasis. MPs expose at their surface procoagulant molecules such as phosphatidylserin and
tissue factor (TF). All data obtained in mouse models support a role of MPs in venous
thrombosis mediated by the TF activation. Moreover, results from clinical studies showed that
TF-MPs was associated with the risk of venous thrombosis. However, the predictive value of
TF-MPs in the recurrence of VTE is unknown. Besides, no study has taken into account the
recent progresses in the understanding of the role of MPs in haemostasis. Indeed, MPs
vectorize molecules which are not only procoagulant but also profibrinolytic. The net result
depends on a balance between both activities (the coagulo-lytic balance). This balance is can
be measured by two complimentary assays on MPs.
We hypothesized that the coagu-lytic balance of MPs is associated with an increased risk of
VTE recurrence after stopping the anticoagulant treatment.
n/a
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