Thrombosis, Translational Medicine, and
Biomarker Research: Moving the Needle
Joseph R. Shaw, MD, MSc* 1; Stephan Nopp, MD, MSc* 2; Benedicte Stavik, MSc, PhD 3; Kimberley Youkhana, MD 4; Alison L. Michels, MD, PhD 5; Soetkin Kennes, MD 6; Janusz Rak, MD, PhD 7; Hugo ten Cate, MD, PhD 8
1-Department of Medicine University of Ottawa, and The Ottawa Hospital Research Institute Ottawa Canada;
2-Clinical Division of Hematology and Hemostaseology Medical University of Vienna Austria;
3-Department of Hematology and The Research Institute of Internal Medicine Oslo University Hospital Oslo Norway;
4-Medical University of South Carolina Charleston SC USA;
5-Department of Surgery, Division of Vascular Surgery McMaster University Hamilton Canada;
6-Department of Hematology Ghent University Hospital Ghent Belgium;
7-Department of Pediatrics and the Division of Experimental Medicine McGill University Montreal Canada;
8-Cardiovascular Research Institute Maastricht, Maastricht University Maastricht Netherlands.
Arterial and venous thromboembolism are leading causes of morbidity and death worldwide. Despite significant
advances in the diagnosis, prognostication, and treatment of thrombotic diseases over the past 3 decades, the adoption of
findings stemming from translational biomarker research in clinical practice remains limited. Biomarkers provide an opportunity to enhance our understanding of pathophysiological processes and optimize treatment strategies. They hold the promise
of revolutionizing patient care. Still, this potential remains untapped, and several factors impede their use for near-patient applications. We sought to provide an overview of biomarker research in arterial and venous thromboembolic disease. We then
aimed to discuss key barriers to the broader clinical implementation of biomarker research and highlight promising strategies
to overcome them. We emphasize the merits of translational and implementation science to bridge the gaps from bench
to bedside. Innovative trial design, data sharing, and collaborative efforts between academia and industry will be essential.
Purposeful regression methodology using rational conceptual framework design, causal mediation analysis, and artificial intelligence might better leverage the use of observational data. Dedicated translational science training programs geared toward
educating physicians on the appropriate measurement, interpretation, and integration of biomarker data in clinical practice
should foster endorsement by frontline physicians. Finally, we make the case in support of a paradigm shift in cardiovascular
medicine. Improved recognition of biomarker research and a greater emphasis on mechanistic evidence can better equip
clinicians to deal with the uncertainty that defines the practice of thrombosis medicine.