Diagnostic biomarkers in venous thromboembolic disease

Objective: Venous thromboembolism (VTE) is a common disease with serious, often fatal sequelae. The optimal strategy for diagnosis of VTE remains unclear, although considerable progress has been made in this area. Several new biomarkers have showed promise for diagnosis of VTE, and more are under active investigation. We reviewed the literature for studies evaluating these diagnostic biomarkers. Methods: We reviewed the English literature between 1990 and 2015, searching for papers evaluating diagnostic performance of biomarkers in VTE. Results: D-dimer, a fibrin degradation product, has been thoroughly investigated, and performs well in select populations, although it is best as a rule-out test because of its generally low specificity. Soluble P-selectin, a marker of endothelial activation, has shown good diagnostic performance in several studies but has not yet been adopted widely. Others, including cellular adhesion molecules, tissue factor, circulating microparticles, and C-reactive protein, are under investigation, with varying results in a few studies. Conclusions: At this time, D-dimer and P-selectin remain the most clinically valuable. New biomarkers are needed for clinical use in VTE.