{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:50:21Z","timestamp":1791435021278,"version":"4.3.3"},"reference-count":102,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Obesity is a major modifiable risk factor for venous thromboembolism (VTE), driven by adipose tissue dysfunction, chronic inflammation, endothelial dysfunction, hypercoagulability, impaired fibrinolysis, immunothrombosis, and venous stasis. Modern incretin-based therapies induce substantial weight loss and improve multiple cardiometabolic abnormalities that may influence thrombotic risk. To critically evaluate the biological rationale and clinical evidence supporting a potential role of incretin-based therapies in modifying VTE risk, while distinguishing mechanistic plausibility from proven clinical benefit and weight-loss-mediated effects from direct pharmacological actions. Methods: Narrative review of MEDLINE\/PubMed and EMBASE (2000\u20132026), with critical appraisal of mechanistic studies, randomized trials, pharmacoepidemiological evidence, and current clinical recommendations. Results: Experimental and translational studies provide biological plausibility for potential antithrombotic effects of incretin-based therapies through modulation of inflammation, endothelial function, platelet activation, and coagulation pathways; however, these biomarkers are not validated surrogate endpoints for VTE. An expanding body of contemporary observational evidence, including active-comparator studies and target-trial emulations, has generally reported lower rates of VTE, pulmonary embolism, and\/or deep vein thrombosis among patients receiving incretin-based therapies, although effect estimates vary according to population, comparator, and clinical setting. In contrast, recent meta-analyses of randomized trials have not demonstrated a significant reduction in overall VTE and have yielded partly conflicting findings for pulmonary embolism and deep vein thrombosis. Major cardiovascular outcome trials were not specifically designed or powered to assess VTE. Current evidence suggests that sustained weight loss is the most plausible mediator of any potential long-term reduction in VTE risk, whereas a clinically relevant weight-independent antithrombotic effect remains unproven. Conclusions: Incretin-based therapies have a compelling biological rationale and a growing observational signal for potential VTE risk reduction, but current evidence is insufficient to establish a causal protective effect. Any potential long-term benefit appears most plausibly related to sustained weight loss and reversal of obesity-associated prothrombotic abnormalities, while a clinically relevant weight-independent antithrombotic effect remains unproven. Accordingly, these therapies should continue to be prescribed according to established metabolic indications, and any reduction in VTE risk should be regarded as a potential but unconfirmed additional benefit. Dedicated randomized trials with prespecified and adjudicated VTE outcomes are required before VTE prevention can be considered a therapeutic indication.<\/jats:p>","DOI":"10.3390\/jcm15197500","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:50:54Z","timestamp":1790614254000},"page":"7500","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Adipose Tissue Dysfunction to Venous Thromboembolism"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9303-7790","authenticated-orcid":false,"given":"Andrea","family":"Boccatonda","sequence":"first","affiliation":[{"name":"Diagnostic and Therapeutic Interventional Ultrasound Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant\u2019Orsola-Malpighi, Via Massarenti N. 9, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2809-1658","authenticated-orcid":false,"given":"Alice","family":"Brighenti","sequence":"additional","affiliation":[{"name":"Diagnostic and Therapeutic Interventional Ultrasound Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant\u2019Orsola-Malpighi, Via Massarenti N. 9, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7761-7533","authenticated-orcid":false,"given":"Alfredo","family":"Caturano","sequence":"additional","affiliation":[{"name":"Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma University, 00166 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5573-4536","authenticated-orcid":false,"given":"Damiano","family":"D\u2019Ardes","sequence":"additional","affiliation":[{"name":"Institute of \u201cClinica Medica\u201d, Department of Medicine and Aging Science, G. D\u2019Annunzio University of Chieti-Pescara, 66100 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1239-7012","authenticated-orcid":false,"given":"Carlo","family":"Acierno","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliera Regionale San Carlo, 85100 Potenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9227-0360","authenticated-orcid":false,"given":"Vincenzo","family":"Russo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medical Translational Sciences, University of Campania Luigi Vanvitelli, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7066-5292","authenticated-orcid":false,"given":"Caterina","family":"Conte","sequence":"additional","affiliation":[{"name":"Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma University, 00166 Rome, Italy"},{"name":"Obesity and Obesity-Related Cardiometabolic Complications Research Unit, IRCCS MultiMedica, 20099 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6744-383X","authenticated-orcid":false,"given":"Paolo","family":"Simioni","sequence":"additional","affiliation":[{"name":"Internal Medicine, Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine, Padova University Hospital, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0377-3741","authenticated-orcid":false,"given":"Elena","family":"Campello","sequence":"additional","affiliation":[{"name":"Internal Medicine, Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine, Padova University Hospital, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,26]]},"reference":[{"key":"ref_1","unstructured":"(2024). Worldwide trends in underweight and obesity from 1990 to 2022: A pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet, 403, 1027\u20131050."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2146","DOI":"10.1161\/CIRCULATIONAHA.110.951236","article-title":"Venous thromboembolism and atherothrombosis: An integrated approach","volume":"121","author":"Piazza","year":"2010","journal-title":"Circulation"},{"key":"ref_3","first-page":"101258","article-title":"Epidemiology of pulmonary embolism in China, 2021: A nationwide hospital-based study","volume":"54","author":"Zhen","year":"2025","journal-title":"Lancet Reg. Health West. Pac."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"162","DOI":"10.15386\/mpr-1372","article-title":"Association between obesity and venous thromboembolism","volume":"93","author":"Hotoleanu","year":"2020","journal-title":"Med. Pharm. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"106972","DOI":"10.1016\/j.ejim.2026.106972","article-title":"Multiparametric and multi-organ ultrasound assessment of adiposity for cardiovascular risk stratification","volume":"151","author":"Boccatonda","year":"2026","journal-title":"Eur. J. Intern. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1182\/asheducation.V2005.1.1.1","article-title":"Venous thrombosis: The role of genes, environment, and behavior","volume":"2005","author":"Rosendaal","year":"2005","journal-title":"Hematol. Am. Soc. Hematol. Educ. Program."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Boccatonda, A., Bray, A., Marozzi, M.S., Cipollone, A., Lauletta, G., D\u2019Ardes, D., Cicco, S., and Cipollone, F. (2026). From liver to cardiovascular system: The MASLD-ASCVD continuum. Intern. Emerg. Med.","DOI":"10.1007\/s11739-026-04497-6"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1258\/jrsm.2010.100155","article-title":"Prolonged work- and computer-related seated immobility and risk of venous thromboembolism","volume":"103","author":"Healy","year":"2010","journal-title":"J. R. Soc. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2054270416632670","DOI":"10.1177\/2054270416632670","article-title":"Venous thromboembolism risk associated with protracted work- and computer-related seated immobility: A case-control study","volume":"7","author":"Braithwaite","year":"2016","journal-title":"JRSM Open"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"69","DOI":"10.5271\/sjweh.3841","article-title":"Sedentary work and risk of venous thromboembolism","volume":"46","author":"Johannesen","year":"2020","journal-title":"Scand. J. Work. Environ. Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1001\/archinte.168.9.920","article-title":"Exposure to particulate air pollution and risk of deep vein thrombosis","volume":"168","author":"Baccarelli","year":"2008","journal-title":"Arch. Intern. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.ejim.2021.09.019","article-title":"Association between air temperature, air pollution and hospital admissions for pulmonary embolism and venous thrombosis in Italy","volume":"96","author":"Renzi","year":"2022","journal-title":"Eur. J. Intern. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1056\/NEJMoa2032183","article-title":"Once-Weekly Semaglutide in Adults with Overweight or Obesity","volume":"384","author":"Wilding","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1056\/NEJMoa2206038","article-title":"Tirzepatide Once Weekly for the Treatment of Obesity","volume":"387","author":"Jastreboff","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"113271","DOI":"10.1016\/j.diabres.2026.113271","article-title":"GLP-1-based therapies and limb outcomes in PAD: A systematic review and meta-analysis of real-world studies","volume":"236","author":"Boccatonda","year":"2026","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1056\/NEJMoa1603827","article-title":"Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes","volume":"375","author":"Marso","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1056\/NEJMoa1607141","article-title":"Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes","volume":"375","author":"Marso","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/S0140-6736(19)31149-3","article-title":"Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): A double-blind, randomised placebo-controlled trial","volume":"394","author":"Gerstein","year":"2019","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.1056\/NEJMoa2307563","article-title":"Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes","volume":"389","author":"Lincoff","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1007\/s11739-026-04351-9","article-title":"The arterial-venous continuum: Bridging atherosclerosis and chronic venous disease through endothelial dysfunction","volume":"21","author":"Campello","year":"2026","journal-title":"Intern. Emerg. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1896","DOI":"10.1161\/CIRCULATIONAHA.109.921460","article-title":"Risk factors for venous thromboembolism: Results from the Copenhagen City Heart Study","volume":"121","author":"Holst","year":"2010","journal-title":"Circulation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.1365-2141.2007.06780.x","article-title":"Risk of venous thrombosis: Obesity and its joint effect with oral contraceptive use and prothrombotic mutations","volume":"139","author":"Pomp","year":"2007","journal-title":"Br. J. Haematol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.thromres.2020.05.014","article-title":"Relationship between body mass index, risk of venous thromboembolism and pulmonary embolism: A systematic review and dose-response meta-analysis of cohort studies among four million participants","volume":"192","author":"Rahmani","year":"2020","journal-title":"Thromb. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1850","DOI":"10.1161\/CIRCULATIONAHA.109.863241","article-title":"Anthropometry, body fat, and venous thromboembolism: A Danish follow-up study","volume":"120","author":"Severinsen","year":"2009","journal-title":"Circulation"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1001\/archinte.168.15.1678","article-title":"Overweight, obesity, and the risk of recurrent venous thromboembolism","volume":"168","author":"Eichinger","year":"2008","journal-title":"Arch. Intern. Med."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Ntinopoulou, P., Ntinopoulou, E., Papathanasiou, I.V., Fradelos, E.C., Kotsiou, O., Roussas, N., Raptis, D.G., Gourgoulianis, K.I., and Malli, F. (2022). Obesity as a Risk Factor for Venous Thromboembolism Recurrence: A Systematic Review. Medicina, 58.","DOI":"10.3390\/medicina58091290"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Zawadzka, P.S., Imiela, A.M., and Pruszczyk, P. (2025). The Interplay Between Obesity and Venous Thromboembolism: From Molecular Aspects to Clinical Issue. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms262110292"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1007\/s11239-025-03126-x","article-title":"Influence of patient\u2019s weight and body mass index on presentation, time of onset, and impact of postoperative venous thromboembolism (RIETE registry)","volume":"58","author":"Arcelus","year":"2025","journal-title":"J. Thromb. Thrombolysis"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1046\/j.1467-789X.2002.00056.x","article-title":"Obesity, haemostasis and the fibrinolytic system","volume":"3","author":"Mertens","year":"2002","journal-title":"Obes. Rev."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"M\u0142ynarska, E., Bojdo, K., Frankenstein, H., Krawiranda, K., Kustosik, N., Lisi\u0144ska, W., Rysz, J., and Franczyk, B. (2025). Endothelial Dysfunction as the Common Pathway Linking Obesity, Hypertension and Atherosclerosis. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms262010096"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Caturano, A., Rocco, M., Tagliaferri, G., Piacevole, A., Nilo, D., Di Lorenzo, G., Iadicicco, I., Donnarumma, M., Galiero, R., and Acierno, C. (2025). Oxidative Stress and Cardiovascular Complications in Type 2 Diabetes: From Pathophysiology to Lifestyle Modifications. Antioxidants, 14.","DOI":"10.3390\/antiox14010072"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1007\/BF03344054","article-title":"Coagulation and fibrinolysis abnormalities in obesity","volume":"25","author":"Pannacciulli","year":"2002","journal-title":"J. Endocrinol. Invest."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1038\/sj.ijo.0802778","article-title":"Obesity and impaired fibrinolysis: Role of adipose production of plasminogen activator inhibitor-1","volume":"28","author":"Skurk","year":"2004","journal-title":"Int. J. Obes. Relat. Metab. Disord."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Qu, J., Cheng, Y., Wu, W., Yuan, L., and Liu, X. (2021). Glycocalyx Impairment in Vascular Disease: Focus on Inflammation. Front. Cell Dev. Biol., 9.","DOI":"10.3389\/fcell.2021.730621"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/joim.12465","article-title":"The glycocalyx and its significance in human medicine","volume":"280","author":"Tarbell","year":"2016","journal-title":"J. Intern. Med."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Altamura, S., Lombardi, F., Palumbo, P., Cinque, B., Ferri, C., Del Pinto, R., and Pietropaoli, D. (2024). The Evolving Role of Neutrophils and Neutrophil Extracellular Traps (NETs) in Obesity and Related Diseases: Recent Insights and Advances. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms252413633"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3225","DOI":"10.1007\/s11033-022-07157-y","article-title":"Neutrophil extracellular traps (NETs) modulate inflammatory profile in obese humans and mice: Adipose tissue role on NETs levels","volume":"49","author":"Freitas","year":"2022","journal-title":"Mol. Biol. Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2950","DOI":"10.1016\/j.jacc.2020.04.031","article-title":"COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review","volume":"75","author":"Bikdeli","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_39","first-page":"622","article-title":"Effect of obesity on venous blood flow in the lower limbs","volume":"21","author":"Langan","year":"2023","journal-title":"J. Dtsch. Dermatol. Ges."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Ortega, M.A., Fraile-Mart\u00ednez, O., Garc\u00eda-Montero, C., \u00c1lvarez-Mon, M.A., Chaowen, C., Ruiz-Grande, F., Pekarek, L., Monserrat, J., As\u00fansolo, A., and Garc\u00eda-Honduvilla, N. (2021). Understanding Chronic Venous Disease: A Critical Overview of Its Pathophysiology and Medical Management. J. Clin. Med., 10.","DOI":"10.3390\/jcm10153239"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"3161","DOI":"10.1182\/blood.2021011145","article-title":"Calf muscle pump dysfunction and VTE risk","volume":"137","author":"Obi","year":"2021","journal-title":"Blood"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Liu, F., Tan, J., and Pan, Y. (2025). Prevention of deep vein thrombosis in postoperative orthopedic patients: A hybrid meta-analysis and clinical case study. Front. Med., 12.","DOI":"10.3389\/fmed.2025.1603191"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"377","DOI":"10.4103\/1947-2714.139286","article-title":"Reduced fibrinogen, fibrinolytic biomarkers, and physical parameters after a weight-loss program in obese subjects","volume":"6","author":"Aziz","year":"2014","journal-title":"N. Am. J. Med. Sci."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1177\/0962280207082719","article-title":"The Biomarker-Surrogacy Evaluation Schema: A review of the biomarker-surrogate literature and a proposal for a criterion-based, quantitative, multidimensional hierarchical levels of evidence schema for evaluating the status of biomarkers as surrogate endpoints","volume":"17","author":"Lassere","year":"2008","journal-title":"Stat. Methods Med. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1007\/s11739-016-1397-7","article-title":"Dynamics of circulating microparticles in obesity after weight loss","volume":"11","author":"Campello","year":"2016","journal-title":"Intern. Emerg. Med."},{"key":"ref_46","first-page":"e33444","article-title":"Thromboembolic Complications After Bariatric Surgery: Is the High Risk Real?","volume":"15","author":"Carvalho","year":"2023","journal-title":"Cureus"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1007\/s11695-024-07236-y","article-title":"Bariatric Surgery and the Long-Term Risk of Venous Thromboembolism: A Population-Based Cohort Study","volume":"34","author":"Harrington","year":"2024","journal-title":"Obes. Surg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1898","DOI":"10.1177\/00031348251339525","article-title":"Venous Thromboembolism After Bariatric Surgery: An Analysis of Predictors and Trends in Two Large Datasets","volume":"91","author":"Leslie","year":"2025","journal-title":"Am. Surg."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1002\/oby.20461","article-title":"Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: Cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery","volume":"21","author":"Mechanick","year":"2013","journal-title":"Obesity"},{"key":"ref_50","first-page":"Cd013683","article-title":"Pharmacological interventions for preventing venous thromboembolism in people undergoing bariatric surgery","volume":"11","author":"Amaral","year":"2022","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e2315241","DOI":"10.1001\/jamanetworkopen.2023.15241","article-title":"Efficacy and Safety of Rivaroxaban for Postoperative Thromboprophylaxis in Patients After Bariatric Surgery: A Randomized Clinical Trial","volume":"6","author":"Nett","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"5","DOI":"10.5604\/01.3001.0016.2729","article-title":"Prolonged thromboprophylaxis with rivaroxaban after bariatric interventions: Single centre experience","volume":"95","author":"Tyselskyi","year":"2023","journal-title":"Pol. Przegl Chir."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1002\/ajh.70186","article-title":"Association Between Bariatric Surgery and the Long-Term Risk for Venous Thromboembolism: A Population-Based Matched Cohort Study","volume":"101","author":"Simard","year":"2026","journal-title":"Am. J. Hematol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1007\/s11739-026-04363-5","article-title":"Venous thromboembolism with modern glucose-lowering agents in diabetes: Active-comparator evidence beyond placebo-based meta-analyses","volume":"21","author":"Boccatonda","year":"2026","journal-title":"Intern. Emerg. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1038\/s44324-024-00030-5","article-title":"Incretin-based therapies for the treatment of obesity-related diseases","volume":"2","author":"Caruso","year":"2024","journal-title":"npj Metab. Health Dis."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Lee, A.A., Khotina, V.A., Kashirskikh, D.A., Voronko, O.E., Gasanov, V.A.O., and Vasiliev, A.V. (2025). Incretin-Based Therapies Through the Decades: Molecular Innovations and Clinical Impact. Med. Sci., 13.","DOI":"10.3390\/medsci13040269"},{"key":"ref_57","first-page":"179674","article-title":"Pharmacotherapies for obesity: Past, current, and future therapies","volume":"2011","author":"Piccenna","year":"2011","journal-title":"J. Obes."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/pin.13305","article-title":"Underlying mechanisms of thrombus formation\/growth in atherothrombosis and deep vein thrombosis","volume":"73","author":"Yamashita","year":"2023","journal-title":"Pathol. Int."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1038\/s41572-019-0106-z","article-title":"Atherosclerosis","volume":"5","author":"Libby","year":"2019","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1016\/j.jacc.2025.08.027","article-title":"Cardiovascular Effects and Tolerability of GLP-1 Receptor Agonists: A Systematic Review and Meta-Analysis of 99,599 Patients","volume":"86","author":"Galli","year":"2025","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.tcm.2015.12.001","article-title":"Tissue factor as a link between inflammation and coagulation","volume":"26","author":"Witkowski","year":"2016","journal-title":"Trends Cardiovasc. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1042\/BCJ20210522","article-title":"Immunothrombosis and the molecular control of tissue factor by pyroptosis: Prospects for new anticoagulants","volume":"479","author":"Ryan","year":"2022","journal-title":"Biochem. J."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1056\/NEJMoa022157","article-title":"An association between atherosclerosis and venous thrombosis","volume":"348","author":"Prandoni","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.jacbts.2022.04.004","article-title":"Glucagon-Like Peptide-1 Receptor Regulates Thromboxane-Induced Human Platelet Activation","volume":"7","author":"Cahill","year":"2022","journal-title":"JACC Basic. Transl. Sci."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"106320","DOI":"10.1016\/j.phrs.2022.106320","article-title":"The anti-inflammatory and immunological properties of GLP-1 Receptor Agonists","volume":"182","author":"Bendotti","year":"2022","journal-title":"Pharmacol. Res."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"152822","DOI":"10.1016\/j.bbrc.2025.152822","article-title":"GLP-1 receptor agonists and inflammatory pathway modulation: Dual targeting of metabolic and immune dysfunction in insulin resistance","volume":"789","author":"Ngabea","year":"2025","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.2337\/db15-1141","article-title":"Glucagon-Like Peptide 1 Receptor Activation Attenuates Platelet Aggregation and Thrombosis","volume":"65","author":"Reheman","year":"2016","journal-title":"Diabetes"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1160\/TH16-07-0586","article-title":"Glucagon-like peptide 1-related peptides increase nitric oxide effects to reduce platelet activation","volume":"117","author":"Barale","year":"2017","journal-title":"Thromb. Haemost."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Simeone, P., Liani, R., Tripaldi, R., Di Castelnuovo, A., Guagnano, M.T., Tartaro, A., Bonadonna, R.C., Federico, V., Cipollone, F., and Consoli, A. (2018). Thromboxane-Dependent Platelet Activation in Obese Subjects with Prediabetes or Early Type 2 Diabetes: Effects of Liraglutide- or Lifestyle Changes-Induced Weight Loss. Nutrients, 10.","DOI":"10.3390\/nu10121872"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"108188","DOI":"10.1016\/j.jdiacomp.2022.108188","article-title":"A pilot clinical study to Evaluate Liraglutide-mediated Anti-platelet activity in patients with type-2 Diabetes (ELAID study)","volume":"36","author":"Loganathan","year":"2022","journal-title":"J. Diabetes Complicat."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.thromres.2019.06.010","article-title":"Hypercholesterolemia impairs the Glucagon-like peptide 1 action on platelets: Effects of a lipid-lowering treatment with simvastatin","volume":"180","author":"Barale","year":"2019","journal-title":"Thromb. Res."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1507\/endocrj.EJ21-0129","article-title":"Comprehensive analysis of the safety of semaglutide in type 2 diabetes: A meta-analysis of the SUSTAIN and PIONEER trials","volume":"68","author":"Yin","year":"2021","journal-title":"Endocr. J."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"e039446","DOI":"10.1161\/JAHA.124.039446","article-title":"Glucagon-Like Peptide-1 Receptor Agonists and Risk of Venous Thromboembolism: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"14","author":"Liu","year":"2025","journal-title":"J. Am. Heart Assoc."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"3527","DOI":"10.1016\/j.jtha.2025.06.020","article-title":"Glucagon-like peptide 1 receptor agonists and risk of venous thromboembolism: A systematic review and meta-analysis of randomized controlled trials","volume":"23","author":"Chiang","year":"2025","journal-title":"J. Thromb. Haemost."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"2410","DOI":"10.1182\/bloodadvances.2025015871","article-title":"Glucagon-like peptide 1 receptor agonists and venous thromboembolism in type 2 diabetes: A target trial emulation","volume":"9","author":"Chiang","year":"2025","journal-title":"Blood Adv."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"e047893","DOI":"10.1161\/JAHA.125.047893","article-title":"Glucagon-Like Peptide-1 Receptor Agonists and Cardiovascular Events in Adults With Obesity and Autoimmune Disease: A Target Trial Emulation","volume":"15","author":"Dai","year":"2026","journal-title":"J. Am. Heart Assoc."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"102557","DOI":"10.1016\/j.jvsv.2026.102557","article-title":"Glucagon-like peptide-1 receptor agonists are associated with fewer venous thromboembolic events and limb complications in obese patients with chronic venous insufficiency","volume":"14","author":"Micalo","year":"2026","journal-title":"J. Vasc. Surg. Venous Lymphat. Disord."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1604","DOI":"10.1210\/clinem\/dgaf703","article-title":"GLP-1 receptor agonists in patients with cancer are associated with reduced all-cause mortality and hospitalization","volume":"111","author":"Mahadevan","year":"2026","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"348","DOI":"10.2106\/JBJS.24.00468","article-title":"Glucagon-Like Peptide-1 Receptor Agonists Decrease Medical and Surgical Complications in Morbidly Obese Patients Undergoing Primary TKA","volume":"107","author":"Kim","year":"2025","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Marzook, F.A., Kesaria, A.A., Glover, J.M., and Alijanipour, P. (2026). Preoperative Use of GLP-1 Receptor Agonists Is Associated With Reduced Risk of Postoperative DVT and Mortality in Patients Undergoing Lumbar Laminectomy. Clin. Spine Surg., Publish Ahead of Print.","DOI":"10.1097\/BSD.0000000000002113"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.bjps.2026.03.001","article-title":"GLP-1 receptor agonist use and surgical outcomes following diabetic foot reconstruction: A propensity score-matched retrospective cohort study","volume":"116","author":"Zhang","year":"2026","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/j.spinee.2025.12.019","article-title":"Glucagon-like peptide-1 receptor agonist use and perioperative outcomes after anterior cervical discectomy and fusion: A propensity-matched cohort study","volume":"26","author":"Heo","year":"2026","journal-title":"Spine J."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1016\/j.jhsa.2025.08.004","article-title":"Glucagon-like peptide-1 Agonists and Common Hand Procedures: Perioperative and Postoperative Risks and Complications","volume":"50","author":"Amen","year":"2025","journal-title":"J. Hand Surg. Am."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Wu, J.Y., Lee, K.W., Huang, S.C., Chang, H.Y., and Lin, Y.M. (2026). Comparative effectiveness of tirzepatide versus GLP-1 receptor agonists on the risk of venous thromboembolism in patients with obesity: A real-world cohort study. Front. Med., 13.","DOI":"10.3389\/fmed.2026.1820366"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Kahkedjian, F., Shah, J., and Kreidieh, F. (2026). Tirzepatide and reduced risk of pulmonary embolism and deep vein thrombosis: A multicenter U.S. cohort study. Front. Endocrinol., 17.","DOI":"10.3389\/fendo.2026.1885961"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"102915","DOI":"10.1016\/j.eclinm.2024.102915","article-title":"Real-world data: Bridging the gap between clinical trials and practice","volume":"78","author":"Wilson","year":"2024","journal-title":"eClinicalMedicine"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1093\/aje\/kwm324","article-title":"Immortal time bias in pharmaco-epidemiology","volume":"167","author":"Suissa","year":"2008","journal-title":"Am. J. Epidemiol."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Benchimol, E.I., Smeeth, L., Guttmann, A., Harron, K., Moher, D., Petersen, I., S\u00f8rensen, H.T., von Elm, E., and Langan, S.M. (2015). The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement. PLoS Med., 12.","DOI":"10.1371\/journal.pmed.1001885"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"oeaf170","DOI":"10.1093\/ehjopen\/oeaf170","article-title":"GLP-1 agonist, semaglutide use in acute pulmonary embolism recovery: A four-week proof-of-concept study including proteomic profiling","volume":"6","author":"Samaranayake","year":"2026","journal-title":"Eur. Heart J. Open"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.1111\/imj.70522","article-title":"Glucagon-like peptide-1 receptor agonists and venous thromboembolism: An unresolved question for Australian prescribers","volume":"56","author":"Kamel","year":"2026","journal-title":"Intern. Med. J."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"otag027","DOI":"10.1093\/crocol\/otag027","article-title":"Comparison of IBD-related outcomes in patients with obesity treated with GLP-1 receptor agonists versus bariatric surgery","volume":"8","author":"Nanah","year":"2026","journal-title":"Crohns Colitis 360"},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Mansory, E.M., and Radhwi, O.O. (2026). Pharmacovigilance Assessment of Thrombotic Adverse Events Linked to GLP-1 Receptor Agonists: Analysis of FAERS Reports from 2020\u20132025. Curr. Drug Saf.","DOI":"10.2174\/0115748863468899260323094036"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1182\/hematology.2023000492","article-title":"Provoked vs minimally provoked vs unprovoked VTE: Does it matter?","volume":"2023","author":"Becattini","year":"2023","journal-title":"Hematol. Am. Soc. Hematol. Educ. Program."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1979","DOI":"10.1007\/s11739-026-04384-0","article-title":"Effects of glucagon-like peptide-1 receptor agonists and dual glucagon-like peptide-1 receptor agonists\/glucose-dependent insulinotropic polypeptide on liver stiffness and steatosis evaluated through Fibroscan\u00ae: A systematic review and meta-analysis","volume":"21","author":"Berardicurti","year":"2026","journal-title":"Intern. Emerg. Med."},{"key":"ref_95","first-page":"475","article-title":"Bariatric and general surgical procedures in obese patients with a history of venous thromboembolism and concurrent anticoagulation therapy","volume":"92","author":"Howell","year":"2024","journal-title":"Cir. Cir."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1111\/jth.15358","article-title":"Use of direct oral anticoagulants in patients with obesity for treatment and prevention of venous thromboembolism: Updated communication from the ISTH SSC Subcommittee on Control of Anticoagulation","volume":"19","author":"Martin","year":"2021","journal-title":"J. Thromb. Haemost."},{"key":"ref_97","first-page":"320","article-title":"Safety and Efficacy of Direct Oral Anticoagulants Compared to Warfarin in Patients with Venous Thromboembolism and Morbid Obesity","volume":"19","author":"Katel","year":"2025","journal-title":"Int. J. Hematol. Oncol. Stem Cell Res."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"e50355","DOI":"10.1097\/MD.0000000000050355","article-title":"Safety and efficacy of direct acting oral anticoagulants in the treatment of patients with morbid obesity with venous thromboembolism: A meta-analysis","volume":"105","author":"Shi","year":"2026","journal-title":"Medicine"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"3033","DOI":"10.1016\/j.jtha.2025.06.025","article-title":"A systematic review on anti-Xa monitoring in the therapeutic use of low-molecular-weight heparins","volume":"23","author":"Jaspers","year":"2025","journal-title":"J. Thromb. Haemost."},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Zhu, S., Ni, Q., and He, J. (2026). Revisiting low-molecular-weight heparin for venous thromboembolism: From pharmacology to precision dosing and implementation. Front. Pharmacol., 17.","DOI":"10.3389\/fphar.2026.1824218"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/j.thromres.2007.10.011","article-title":"Physical activity in patients with deep venous thrombosis: A systematic review","volume":"122","author":"Kahn","year":"2008","journal-title":"Thromb. Res."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1055\/a-2712-3534","article-title":"Nonanticoagulant Strategies for Venous Thromboembolism Prophylaxis","volume":"52","author":"Gurumurthy","year":"2026","journal-title":"Semin. Thromb. Hemost."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7500\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:10:23Z","timestamp":1791432623000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7500"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,26]]},"references-count":102,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["jcm15197500"],"URL":"https:\/\/doi.org\/10.3390\/jcm15197500","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,26]]}}}