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<p>Complement factor H (CFH), a key regulatory protein, has demonstrated antithrombotic properties in experimental models. However, the association between circulating CFH levels and the clinical prognosis of deep vein thrombosis (DVT), particularly the risk of recurrence, remains unexplored in human studies. To investigate the association between baseline serum CFH levels and the long-term risk of recurrent DVT. In this prospective cohort study, patients with a first-time DVT were consecutively enrolled between January 2019 and April 2024. Baseline serum CFH levels were quantified by ELISA, with blood samples collected at hospital admission for the first DVT and prior to the initiation of anticoagulation therapy. High CFH was defined as ≥ 2517.22 ng/mL. Patients were followed for up to five years for objectively confirmed DVT recurrence. The association between CFH levels and DVT recurrence risk was analyzed using cumulative incidence function (CIF) curves, competing risk regression model (Fine-Gray model, with death treated as a competing event), and receiver operating characteristic (ROC) analysis. This study consecutively enrolled 237 patients with DVT. Over a median follow-up of 48 months (IQR, 6.5–60), 23 patients (9.7%) experienced recurrence. Patients with high baseline complement factor H (CFH) levels (≥ 2517.22 ng/mL) had a significantly lower cumulative incidence of recurrence than those with low levels, after accounting for the competing risk of death (Gray’s test, <i>P</i> = 0.013). In Fine-Gray competing risk models, high CFH remained an independent protective factor against recurrence after multivariable adjustment (subdistribution hazard ratio [sHR] = 0.37, 95% CI: 0.16–0.84, <i>P</i> = 0.018). Each unit increase in log-transformed CFH was also associated with reduced risk (sHR = 0.43, 95% CI: 0.23–0.78, <i>P</i> = 0.006). The area under the ROC curve for CFH was 0.688, with a 10-fold cross-validated estimate of 0.630. Our findings suggest an inverse association between higher baseline serum CFH levels and the risk of DVT recurrence, indicating its potential as a candidate biomarker for risk stratification that warrants further validation.</p> Graphical Abstract <p></p>

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Complement Factor H as a Novel Predictive Biomarker for Deep Vein Thrombosis Recurrence: A Prospective Cohort Study

  • 期刊论文

  • 发表日期：

    2026年4月17日

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  • Qian Yi,
  • Fei Wang,
  • Mingyi Zhang,
  • Xue Chen,
  • Yueqin Liu,
  • Mingdong Wu,
  • Wu Yu,
  • Yikuan Chen,
  • Xiaoqing Bu

摘要

Complement factor H (CFH), a key regulatory protein, has demonstrated antithrombotic properties in experimental models. However, the association between circulating CFH levels and the clinical prognosis of deep vein thrombosis (DVT), particularly the risk of recurrence, remains unexplored in human studies. To investigate the association between baseline serum CFH levels and the long-term risk of recurrent DVT. In this prospective cohort study, patients with a first-time DVT were consecutively enrolled between January 2019 and April 2024. Baseline serum CFH levels were quantified by ELISA, with blood samples collected at hospital admission for the first DVT and prior to the initiation of anticoagulation therapy. High CFH was defined as ≥ 2517.22 ng/mL. Patients were followed for up to five years for objectively confirmed DVT recurrence. The association between CFH levels and DVT recurrence risk was analyzed using cumulative incidence function (CIF) curves, competing risk regression model (Fine-Gray model, with death treated as a competing event), and receiver operating characteristic (ROC) analysis. This study consecutively enrolled 237 patients with DVT. Over a median follow-up of 48 months (IQR, 6.5–60), 23 patients (9.7%) experienced recurrence. Patients with high baseline complement factor H (CFH) levels (≥ 2517.22 ng/mL) had a significantly lower cumulative incidence of recurrence than those with low levels, after accounting for the competing risk of death (Gray’s test, P = 0.013). In Fine-Gray competing risk models, high CFH remained an independent protective factor against recurrence after multivariable adjustment (subdistribution hazard ratio [sHR] = 0.37, 95% CI: 0.16–0.84, P = 0.018). Each unit increase in log-transformed CFH was also associated with reduced risk (sHR = 0.43, 95% CI: 0.23–0.78, P = 0.006). The area under the ROC curve for CFH was 0.688, with a 10-fold cross-validated estimate of 0.630. Our findings suggest an inverse association between higher baseline serum CFH levels and the risk of DVT recurrence, indicating its potential as a candidate biomarker for risk stratification that warrants further validation.

Graphical Abstract