Bridging the post-discharge management gap in venous thromboembolism: linking adherence patterns to persistent...

Area of Science:

• Vascular Surgery
• Hematology
• Biomarker Research

Background:

• Venous thromboembolism (VTE) management often focuses on acute treatment, with less emphasis on long-term post-discharge adherence to preventive measures.
• Persistent hypercoagulability following VTE diagnosis can indicate ongoing risk, but its relationship with adherence to preventive strategies requires further elucidation.
• D-dimer levels serve as a sensitive biomarker for VTE and hypercoagulability, offering a measurable endpoint for assessing treatment effectiveness.

Purpose of the Study:

• To investigate the association between post-discharge adherence to VTE preventive measures and the resolution of hypercoagulability, measured by D-dimer levels.
• To identify predictors of persistent hypercoagulability after VTE diagnosis and treatment.
• To evaluate the impact of adherence to anticoagulant and compression therapies on biomarker trajectories.

Main Methods:

• A prospective cohort study of 110 patients with confirmed VTE diagnoses was conducted.
• Patients were categorized into complete, partial, and non-adherence groups based on post-discharge compliance with therapies.
• D-dimer levels were measured at baseline and 90-day follow-up, with statistical analyses including ANOVA and multivariable linear regression.

Main Results:

• Only 38.4% of patients consistently used compression stockings, with adherence dropping significantly between 30 and 60 days post-discharge.
• Complete adherence was associated with substantial D-dimer reduction (Δ -4.87 μg/mL), while non-adherence showed minimal change (Δ -0.52 μg/mL).
• Current smoking and non-adherence status were significant predictors of sustained D-dimer elevation.

Conclusions:

• A direct link exists between the post-discharge management gap in VTE care and persistent hypercoagulability.
• VTE should be considered a chronic high-risk condition requiring structured, long-term management strategies.
• Interventions focusing on the critical 60-day transition period and smoking cessation are recommended for sustained VTE risk control.