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Recent Pathophysiological Insights Are Advancing the Treatment of Venous Thromboembolism

Satish Singh1, Pardeep Kumar2, Sudesh K Yadav2

  • 1CSIR-Institute of Himalayan Bioresource Technology, Palampur, Himachal Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India; Translational Cardiovascular Research Center, Department of Medicine, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA.

JACC. Basic to Translational Science
|May 28, 2025
PubMed

Insights

Venous thromboembolism (VTE) causes significant cardiovascular deaths. This review explores thrombus aging mechanisms and novel pharmacotherapeutic strategies for VTE, aiming for improved safety and efficacy.

Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Pharmacology

Background:

  • Venous thromboembolism (VTE), encompassing deep vein thrombosis and pulmonary embolism, is a major cause of cardiovascular mortality.
  • Unresolved venous thrombi can lead to chronic complications like post-thrombotic syndrome and chronic thromboembolic pulmonary hypertension.
  • Aging thrombi develop fibrotic changes, rendering them unresponsive to current treatments.

Purpose of the Study:

  • To review the mechanisms of venous thrombus aging.
  • To discuss the clinical implications of thrombus aging.
  • To present the latest pharmacotherapeutic developments for VTE.

Main Methods:

  • Literature review of venous thrombus aging.
  • Analysis of current and emerging VTE pharmacotherapies.
  • Discussion of therapeutic strategies targeting acute and transition phases of VTE.

Main Results:

  • Venous thrombus composition evolves from acute to chronic, fibrotic states.
  • Standard anticoagulation has limitations in preventing recurrence and carries bleeding risks.
  • Novel drug discovery targets acute VTE, while anti-inflammatory agents, statins, and vasodilators are explored for the acute-to-chronic transition.

Conclusions:

  • Understanding thrombus aging is crucial for developing effective VTE treatments.
  • Emerging pharmacotherapies offer potential for enhanced safety and efficacy in VTE management.
  • Targeting different stages of VTE, from acute to chronic, is key to improving patient outcomes.

Keywords:
CTEPHFactor XIPTSfibrinolysis inhibitorsthrombus compositionvenous thromboembolismvenous thrombosis

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