The formation of venous blood clots in the deep veins of the body or in the blood vessels of the lungs, also known as venous thromboembolism (VTE), is a common and potentially fatal condition in cancer. Our recent research data show improved survival in cancer patients with VTE.
Improved survival in cancer patients with venous thrombosis
The formation of venous blood clots in the deep veins of the body or in the blood vessels of the lungs, also known as venous thromboembolism (VTE), is a common and potentially fatal condition in cancer. Our recent research data show improved survival in cancer patients with VTE.
Treatment of cancer and VTE has improved in recent decades, but to what extent these improvements have been accompanied by improved survival for cancer patients with VTE remains unclear. Nikolai H. Eide, an MD/PhD student at the Thrombosis Research Group (TREC), and his colleagues at UiT and UNN sought to answer this question by investigating the changes in mortality over the last three decades for cancer patients with VTE.
MD/PhD-student Nikolai Eide in TREC Photo: Private
The researchers analyzed data from two large Norwegian population-based studies, the Tromsø Study and the Trøndelag Health Study (HUNT). A total of 111,119 participants were followed from 1994 to 2019 to explore changes in mortality rates among cancer patients with VTE.
We found that the proportion of patients who died within 1 year after the diagnosis of cancer-related VTE decreased from 62% to 45% in the period 1994 to 2019. The improved survival over time was particularly seen for cancer patients without metastasis, that is, without spread of the cancer cells in the body at the time of cancer diagnosis.
While the study did not pinpoint the exact reasons for the improved survival of cancer-related VTE, several factors might have contributed, especially those related to the major advances in cancer treatment that have been achieved in recent decades. The findings from Eide and colleagues give hope for the future of cancer patients, their families and doctors, and form the basis for further research dedicated to improve the survival in cancer patients with VTE.
Reference: Eide NH, Langholm C, Rinde FB, Van Es N, Hveem K, Brækkan SK, Hansen JB, Morelli VM. Mortality risk after cancer-related venous thromboembolism has decreased over the last three decades: the HUNT and Tromsø studies. Haematologica 2025. Link: https://pubmed.ncbi.nlm.nih.gov/39945012/
Illustration: Cancer patient receiving therapy. Photo: www.mostphotos.comLenke til nyhet
In a large proteome-wide analysis of over 7000 proteins, we have discovered five new protein candidates associated with venous thromboembolism (VTE)
Proteome wide study reveals novel biomarkers for VTE
In a large proteome-wide analysis of over 7000 proteins, we have discovered five new protein candidates associated with venous thromboembolism (VTE)
Illustration: Blood clot in lungs (www.Mostphotos.com)
A systematic profiling of the plasma proteome can provide new insight into molecular pathways involved in the pathogenesis of venous thromboembolism (VTE) and reveal potential predictive biomarkers or drug targets. Previous proteomic studies on VTE were restricted to up to 500 proteins. Therefore, we performed a large proteome-wide discovery case-cohort study of individuals who developed VTE within the five years after baseline blood sampling (n=294) and a randomly sampled subcohort (n=1066) derived from the Trøndelag Health Study. We screened plasma samples for >7000 proteins using the SomaScan aptamer-based proteomics platform. In the proteome wide analyses, 7 proteins were significantly associated with future VTE after correction for multiple testing. Of these, 5 proteins were novel candidates associated with VTE. Protein pathway analyses of the top-ranked 200 proteins associated with VTE revealed significant enrichment of 9 proteins in the complement and coagulation pathways, particularly the lectin pathway of the complement system and the intrinsic coagulation pathway.
Recent findings suggest that miR-145 may be protective against thrombosis.
New finding: MicroRNA associated with lower risk of VTE!
Recent findings suggest that miR-145 may be protective against thrombosis.
icroRNAs (miRs) are small non-coding RNAs that downregulate gene expression. Interestingly, miR-145 has been reported to downregulate the expression of important factors in the coagulation system (tissue factor and factor XI) in vitro. Furthermore, miR-145 has be shown to decrease venous thrombus formation in a mouse model.
MicroRNA (Illusteration created with BioRender)
In a recent paper, published in Blood, we investigated the association between plasma levels of miR-145 and risk of future VTE. We found that plasma levels of miR-145 were inversely associated with VTE risk. Participants with miR-145 levels in the highest quartile had a 49% lower risk of VTE compared with those with miR-145 in the lowest quartile, and this association remained after adjustment for several potential confounders. Our observation of a protective role of miR-145 for VTE, implies that miR-145 could be a potential target for VTE prevention in the future.
TREC presented recent results at ECTH2023 in Valencia
The European Congress on Thrombosis and Haemostasis (ECTH) was held in Valencia, Spain, 13-15 of September, 2023. The conference had more than 300 participants, and the TREC team was present with 11 members. We had submitted 12 abstracts, of which 8 were selected for oral presentations and 4 for poster presentations.Nikolai Eide (MD-PhD Student) had an impressive presentation on mortality after cancer-related VTE in the Science fast and furious session. The eight top-ranked abstracts of the conference were chosen for this type of presentation, and the presenters were coached to present on stage in a TEDx format.We also presented recent findings from the PREVENT, NOR-CAT, MISSION-VTE and CARTIER projects, among others. Professor Sigrid Brækkan held a state-of-the-art presentation on atherosclerotic risk factors and venous thrombosis, and professor John-Bjarne Hansen held a Meet the expert session on risk factors of thrombosis. Vårin Wikan (MD-PhD student) won a price for best scientific poster.In addition to all the great science, we had a great time together in Valencia!
In a recent study, we showed that 1/4 of all venous thromboembolism (VTE) events in the population can be attributed to overweight and obesity.
Overweight and obesity – a major contributor to VTE
In a recent study, we showed that 1/4 of all venous thromboembolism (VTE) events in the population can be attributed to overweight and obesity.
Obesity has emerged as one of the most relevant modifiable risk factors for venous thromboembolism (VTE) over the past decades. Obesity is associated with a two- to three-fold increased risk of VTE, and the risk increases linearly with increasing body mass index (BMI). However, data on the proportion of incident VTEs attributed to overweight and obesity in the general population are limited. We therefore investigated the population attributable fraction of overweight and obesity for VTE using data from the 4-7 surveys of the Tromsø study. More than 36 000 people were included in the study and followed for a median of 14 years.
We found that almost 25% of all VTEs in the population could be attributed to overweight and obesity. Thus, from a public health perspective, overweight and obesity are major contributors to the VTE burden in the general population. Our findings further suggest that public health efforts to lower the prevalence of obesity along with targeted interventions to reduce thrombosis risk in overweight and obese individuals may substantially lower the incidence of VTE in the general population.
The paper was published online in Thrombosis and Haemostasis in August 2023, and it also received an accompanying editorial commentary.
Large platelets and high FVIII yields excessive VTE risk
High levels of coagulation factor VIII (FVIII) and large platelets (reflected by a high mean platelet volume [MPV]), are separately associated with increased risk of venous thromboembolism (VTE). Whether the combination of the two yields excessive VTE risk has not been studied. We therefore assessed the combined effects of MPV and FVIII on risk of VTE in a nested case-control study. We found that individuals with high MPV and high FVIII (highest tertiles) had a 2.7-fold higher risk of VTE compared to those with low levels of both factors (lowest tertiles). In those with the combined exposure, 52% of the VTE could be attributed to the biological interaction between MPV and FVIII. These findings support that large platelets could play a role for the mechanism by which high FVIII increases VTE risk.
Weak hand grip strenght was associated with increased risk of recurrence after a first venous thromboembolism.
Grip strength and risk of recurrence after first VTE
Weak hand grip strenght was associated with increased risk of recurrence after a first venous thromboembolism.
There is limited knowledge about the relationship between muscle strength and risk of recurrence and mortality after a first event of venous thromboembolism (VTE). We investigated the relationship between hand grip strength and mortality in 545 participants with a first VTE recruited from the Tromsø study. We found that a weak hand grip strength was associated with a 2-fold increased risk of recurrent VTE and a 34% increased risk of death.
To read more about our findings, please follow this link:
C1-inhibitor is an important inhibitor of the complement system. This protein is also known to inhibit several proteases involved in the coagulation system. In a newly published study, we investigated the association between plasma levels of C1-inhibitor and risk of venous thromboembolism (VTE). In addition, we investigated the effect of C1-inhibitor on thrombin generation ex vivo. We found that individuals with high levels of C1 inhibitor (highest quartile) had a 32% lower risk of VTE. We also showed that C1 inhibitor inhibited thrombin generation initiated by the intrinsic coagulation pathway.
K.G. Jebsen Thrombosis Research and Expertise Center (K.G. Jebsen TREC) was supported by an independent research grant from Stiftelsen Kristian Gerhard Jebsen in the period 2014-2020.
You can read more about our activities in this period on the K.G. Jebsen TREC blog available at https://site.uit.no/trec/.
We aim to reduce the suffering and burden of venous thrombosis through excellent and world leading research.
Trombosis Research Group (TREC)
We aim to reduce the suffering and burden of venous thrombosis through excellent and world leading research.
The total suffering and health burden caused by venous thrombosis (VTE) is tremendous. In Norway, one person suffers from VTE every hour and every forth hour one person dies from a VTE-realated cause.
Up to half of the patients who get VTE in their legs are subsequently afflicted with pain and swelling due to reduced circulation. Further, the socioeconomic burden related to treatment of the disease and loss of income due to work-related disability is very high.
Our research
VTE is a common disease with unclear and complicated disease development for which few risk factors are known.
Previous research has revealed some risk factors that can lead to VTE. Still, several factors have not yet been identified, and there is insufficient knowledge about how the known risk factors work together.
In TREC, we combine laboratory research, patient-oriented research and population-based research to reveal new risk factors and mechanisms for the formation of VTE, which in turn can contribute to improved prevention and tailored treatment of the disease.
TREC is a part of the Department of Clinical Medicine at the Faculty of Health Sciences. The group's research activity take place across several disciplines such as medical biology, clinical medicine and community medicine.
TREC also cooperates closely with research environments at other universities and hospitals in Norway and internationally.
TREC was funded by Stiftelsen K. G. Jebsen from 2014-2020 as the first and so far only K. G. Jebsen Center for Medical Research established in Northern Norway.
Thrombosis occurs when a blood clot forms on the inside of a blood vessel, obstructing the flow of blood through the circulatory system.
What is venous thromboembolism?
Thrombosis occurs when a blood clot forms on the inside of a blood vessel, obstructing the flow of blood through the circulatory system.
While arterial blood clots cause heart attacks and strokes, blood clots may also form in the slow-flowing venous system.
Veins are blood vessels that carry blood back to the lungs and heart from the body’s different organs. A deep vein thrombosis is a blood clot formed in a deep vein, usually in the leg, thigh and/or pelvis.
When blood flow through a vein is obstructed by a blood clot, the increased venous pressure below the clot causes swelling and pain in the affected limb.
A part of the blood clot may also break off and travel with the blood stream until it lodges in the lung vessels. This is called pulmonary embolism, and may result in shortness of breath, chest pain, heart failure and death.
Collectively, deep vein thrombosis and pulmonary embolism are called venous thromboembolism (VTE).