D-dimer as a risk factor for deep vein thrombosis: the Leiden Thrombophilia Study.
We studied the association of D-dimer with the risk of deep vein thrombosis (DVT). D-dimer was measured in 474 patients more than 6 months after diagnosis of a first DVT and in 474 age- and sex-matched controls. For D-dimer above the 70th percentile (130.5 ng/ml), the odds ratio (OR) for DVT was 2.2 (95% CI, 1.6-2.9). The association was unchanged with adjustment for other risk factors. Excluding participants with Factor V Leiden, prothrombin 20210A, or factors VIIIc or IX above the 90th percentile, the OR was 1.6 (95% CI, 1.1-2.3). The risks of DVT with the joint presence of high D-dimer and either factor V Leiden or prothrombin 20210A were increased 12.4-fold (95% CI 5.6-27.7) and 7.2-fold (95% CI 2.1-25.1), respectively. Higher D-dimer concentration was associated with the risk of DVT, and was supra-additive to the risks associated with factor V Leiden and the prothrombin 20210A variant. Persistence of this association in the absence of other hemostatic risk factors for DVT suggests that high D-dimer may be related to other, as yet unknown, risk factors for venous thrombosis. Confirmation of these findings is desirable.
Andreescu
Astrid C M
AC
Department of Medicine, University of Vermont, Burlington, USA.
Cushman
Mary
M
Rosendaal
Frits R
FR
D020413:3' Untranslated Regions / Q000235:genetics; D020016:Activated Protein C Resistance / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015897:Comorbidity; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects; D005165:Factor V / Q000032:analysis; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D018962:Phlebotomy; D011516:Prothrombin / Q000235:genetics; D012307:Risk Factors; D019851:Thrombophilia / Q000097:blood*; D013997:Time Factors; D020246:Venous Thrombosis / Q000097:blood / Q000453:epidemiology*
D020413:3' Untranslated Regions; D003278:Contraceptives, Oral, Hormonal; D005338:Fibrin Fibrinogen Degradation Products; C095381:factor V Leiden; C036309:fibrin fragment D; D005165:Factor V; D011516:Prothrombin