Prospective assessment of the natural history of positive D-dimer results in persons with acute venous thromboembolism (DVT or PE).
The natural history of initially positive D-dimers for venous thromboembolism is not known. If it returns to negative in the majority of patients, it would be potentially helpful to diagnose a recurrence. In this study, we prospectively measured D-dimer levels in outpatients with a diagnosis of venous thromboembolism. There were a total of 152 patients with an average age of 57. D-dimer results were performed at baseline and repeated at one week, one month and three months. At baseline 120 of 152 (79%) had a positive D-dimer result. Of those with an initially positive result, 80% were still positive at one week and 39% were still positive at one month. Finally at three months, 13% remained positive. Seven patients had recurrent events and all had persistently elevated D-dimers at one month. This study suggests that a persistently positive D-dimer result after one month of treatment may indicate a higher risk of recurrent venous thromboembolism. D-dimer testing for the diagnosis of recurrence of venous thromboembolism deserves further study.
Kuruvilla
John
J
Department of Hematology, University of British Columbia, Vancouver, British Columbia, Canada. michael.kovacs@lhsc.on.ca
Wells
Phil S
PS
Morrow
Bev
B
MacKinnon
Karen
K
Keeney
Michael
M
Kovacs
Michael J
MJ
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000150:complications; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood* / Q000209:etiology; D012008:Recurrence; D012306:Risk; D019851:Thrombophilia / Q000097:blood / Q000209:etiology; D013924:Thrombophlebitis / Q000097:blood* / Q000209:etiology
D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D