Identification of novel diagnostic biomarkers for deep venous thrombosis

Summary The combination of a negative D‐dimer and a Wells score can rule out, but not confirm, a diagnosis of deep venous thrombosis ( DVT ). We aimed to identify new diagnostic biomarkers for DVT and to investigate their relationship with hypercoagulability markers [D‐dimer and activated protein C‐protein C inhibitor ( APC ‐ PCI ) complex]. We screened 92 cardiovascular‐specific proteins in plasma samples from 45 confirmed DVT patients and 45 age‐ and sex‐matched non‐ DVT patients selected from a prospective multicentre diagnostic management study ( SCORE ) by Proseek Multiplex CVDIII 96×96 . Plasma levels of 30 proteins were significantly different between DVT and non‐ DVT patients. After Bonferroni correction, plasma levels of seven proteins: P‐selectin, transferrin receptor protein 1, von Willebrand factor, tissue factor pathway inhibitor, osteopontin ( OPN ), bleomycin hydrolase and ST 2 protein remained significantly different. The area under curve ( AUC ) for these proteins ranged from 0·70 to 0·84. Furthermore, all seven identified proteins were significantly associated with markers of hypercoagulability. A combination of OPN and APC ‐ PCI had the best ability to discriminate DVT from non‐ DVT patients ( AUC  = 0·94; sensitivity = 89% and specificity = s84%). In conclusion, we identified multiple proteins associated with markers of hypercoagulability and with a potential to become novel diagnostic biomarkers for DVT .