We asked Mary Cushman, MD, what’s new in the treatment and causes of blood clots
Mary Cushman, MD is a hematologist at the UVM Medical Center and a professor of Medicine and Pathology at the Larner College of Medicine. She serves as the medical director of the Thrombosis and Hemostasis Program.
Q: What is some of the new thinking about blood clots?
A: One of our big shifts is understanding that venous thrombosis (VTE, which includes blood clots that form both in a vein deep in the body – DVT – and in the lungs – PE) is a chronic disease. People who have developed a blood clot often need to stay on anticoagulation medicine long-term. And this is manageable, because now there are several lower-dose medications that are safe and effective to take long-term.
We are also able to treat people on an outpatient basis, which is more convenient for the patient and reduces the risks associated with a hospital stay. Again, the role of newer medications is important – as is our work with the Emergency Department and primary care providers, establishing a network of care so that a blood clot is recognized early on and care is handled through the appropriate providers.
The UVM Medical Center is really leading the nation in a lot of this work. Our research participation nationally has given us a deep and broad knowledge of the latest thinking in the field. There’s a lot of detective work, being creative, solving problems. You really have to know everything going on with the patient; you have to tailor the treatment for each patient. It’s why I went into hematology, and why I continue to be both challenged and rewarded by my work. For me, it’s really a deeply rewarding partnership with my patients – but most important, it’s great for our patients.
Q: Can you talk about the venous thrombosis research you’ve been involved in?
A: Our team in Hematology and Pathology has been working to define risk factors for venous thrombosis (VTE). We’ve participated in many large national studies, following thousands of people over many years. Our research lab does the central lab work for these. We relate baseline characteristics such as exercise, diet, health habits, medical information and lab parameters to outcomes to determine risk factors for developing a blood clot.
We’ve published nearly 100 research papers on risk factors for VTE. One recent one connected the genetics of taller height to thrombosis risk. We’ve also published papers on why people with obesity or longer legs have a higher risk of developing blood clots.
Recently I was named editor-in-chief of Research and Practice in Thrombosis and Haemostasis, an online journal that provides a platform for science and discussion among researchers, clinicians and patients through a broad array of articles in thrombosis, hemostasis and related areas. We are using Twitter to promote discussion and build on the open style of this publication (@RPTHJournal). I hope this approach can help physicians and allow patients access to better care.