Apolipoprotein M and transforming growth factor-β levels as predictive biomarkers in idiopathic recurrent venous thromboembolism

Introduction Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and/or pulmonary embolism (PE), is a common, acute, multifactorial, fatal disease, although treatable. The recurrence rate of VTE is about 17% after 2 years of follow-up and 30% after 8 years. Apolipoprotein M (ApoM) and transforming growth factor-β (TGF-β) could be prognostic biomarkers of recurrence of VTE. Aim of the study The aim of this study was to assess the prognostic value of ApoM and TGF-β levels as predictors of recurrence of VTE among patients with first thrombotic event. Patients and methods This prospective cohort study was carried out from December 2013 to December 2015 in the Internal Medicine, Chest, Anesthesia, Surgical ICU, and Surgery Departments, Tanta University Hospital, Egypt, on 78 patients of both sexes and age younger older than 18 years who were admitted in the hospital for DVT or PE. DVT was confirmed with imaging techniques, venography or compression ultrasonography, and PE was confirmed with ventilation/perfusion lung scan. They were initially treated with low molecular weight heparin and then with warfarin as an oral anticoagulant for 3–6 months. They were observed for 2 years at 3-month intervals in the first year and every 6 months in the second year or until the time of recurrence of VTE. We evaluated the plasma levels of ApoM, TGF-β1, TGF-β2, and TGF-β3 at 3–12 weeks after withdrawal of anticoagulant therapy. Results The main finding in the present study was that the mean plasma levels of both TGF-β1 and TGF-β2 were significantly lower in patients with recurrence of VTE when compared with those without recurrence of VTE. However, the mean plasma levels of ApoM and TGF-β3 were not significantly different between patients with recurrence of VTE and those without recurrence of VTE. Conclusion TGF-β1 and TGF-β2 could be useful prognostic biomarkers in VTEpatients and can predict the recurrence of the thrombotic event.