Thrombosis, Translational Medicine, and Biomarker Research: Moving the Needle

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.