D-dimer prognostic role in thromboembolism occurrence
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D-Dimer Microchapters |
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Clinical Correlation |
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Clinical Trials |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
The association between D-dimer levels and occurrence of VTE is not a causal relationship, but D-dimer level is rather a marker of hemostatic abnormalities that predict higher risk of thromboembolism.
Occurrence of VTE
- The predictive value of D-dimer for the occurrence of VTE has been investigated among 923 subjects from the LITE study which data is a combination of data from the Atherosclerosis Risk in Communities (ARIC) Study and the Cardiovascular Health Study (CHS). VTE was defined as DVT confirmed by positive venogram, duplex, or Doppler ultrasound or PE confirmed by pulmonary angiography. D-dimer were measured in stored blood samples and data about the subjects were obtained from hospital medical records. Elevated levels of D-dimers have been shown to be associated with an increased incidence of VTE in general whether idiopathic or secondary to a non-cancer cause independently of the presence of the commonly inherited coagulopathies. According to this study, elevated levels of D-dimers were not associated with higher risk of cancer-related VTE; nevertheless, this finding might have been influenced by the fact that at the time of withdrawal of blood the subjects did not have cancer.[1]
- A study was conducted in China on 458 patients whose mean age is 77 years and who were hospitalized for at least 3 days for either heart failure, respiratory failure, ischemic stroke, infection or recent surgery in order to evaluate whether elevated D-dimer levels more than 500 ng/ml is associated with high risk of occurrence of VTE in elderly patients hospitalized for acute illness. VTE events were defined as either asymptomatic DVT diagnosed by compression ultrasound at the enrollment day and three weeks afterwards or symptomatic VTE within 90 days of the enrollement. The results of this study were adjusted for gender, age, BMI, the acute medical disease and pre-existing comorbidities and they can be summarized as follow:
References
- ↑ Cushman M, Folsom AR, Wang L, Aleksic N, Rosamond WD, Tracy RP; et al. (2003). "Fibrin fragment D-dimer and the risk of future venous thrombosis". Blood. 101 (4): 1243–8. doi:10.1182/blood-2002-05-1416. PMID 12393393.
- ↑ Fan J, Li X, Cheng Y, Yao C, Zhong N, Investigators Group (2011). "Measurement of D-dimer as aid in risk evaluation of VTE in elderly patients hospitalized for acute illness: a prospective, multicenter study in China". Clin Invest Med. 34 (2): E96–104. PMID 21463550.