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Semin Thromb Hemost 2026; 52(02): 209-218
DOI: 10.1055/a-2704-8487
Review Article

Do we Have the Gut to Beat Thrombosis?

Authors

  • Konstantina Tsante   *

    1   Laboratory of Haematology and Blood Bank Unit, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

  • Eleni Petrou   *

    1   Laboratory of Haematology and Blood Bank Unit, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

  • Stavros Tsalas

    1   Laboratory of Haematology and Blood Bank Unit, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

  • Andreas G. Tsantes 

    1   Laboratory of Haematology and Blood Bank Unit, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

  • Alexandra Lianou 

    2   Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, Piraeus, Greece

  • Georgios Kartelias

    1   Laboratory of Haematology and Blood Bank Unit, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

  • Elias Kyriakou

    1   Laboratory of Haematology and Blood Bank Unit, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

  • Styliani Kokoris

    1   Laboratory of Haematology and Blood Bank Unit, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

  • Georgios Nikolopoulos

    3   Medical School, University of Cyprus, Nicosia, Cyprus

  • Stefanos Bonovas

    4   Department of Biomedical Sciences, Humanitas University, Milan, Italy
    5   IRCCS Humanitas Research Hospital, Milan, Italy

  • Rozeta Sokou

    6   Neonatal Department, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece
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Abstract

Arterial and venous thromboembolism represent major contributors to global morbidity and mortality. Despite substantial progress in risk stratification and clinical management, a significant proportion of thromboembolic events occur in individuals not classified within traditional high-risk groups indicating the involvement of additional, non-conventional risk factors in thrombotic pathophysiology.

Recent evidence has highlighted the gut microbiome as a critical determinant of human health, with increasing recognition of its role in cardiovascular and thrombotic disorders. Furthermore, the gut microbiome constitutes a modifiable risk factor, offering new horizons for therapeutic intervention and emerging evidence suggests that alterations in the microbiome may significantly impact thrombotic risk.

Moreover, microbiome-derived metabolites have gathered considerable scientific attention for their potential involvement in the initiation and progression of thrombosis. These metabolites may serve as novel biomarkers, complementing conventional risk indicators in disease diagnosis, prognosis, screening, and patient monitoring. Microbiome-derived metabolites may hold dual utility, first as diagnostic and prognostic biomarkers, and, second, as potential targets for pharmacologic modulation. Collectively, these findings underscore the growing significance of the gut microbiome as an environmental factor in thromboembolic disease and justify the constantly increasing employment of the scientific community in several aspects of health and disease.

Keywords

gut microbiome - microbiota - thrombosis - cardiovascular disease - TMAO

* These authors have contributed equally to the article.




Publication History

Received: 01 September 2025

Accepted: 18 September 2025

Article published online:
07 October 2025

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