Association of changes in D-dimer and other coagulation markers with changes in Marder score after treatment of acute venous thrombosis.
OBJECTIVE
Coagulation markers are sensitive tools to assess ongoing thrombus formation. An association between changes in these markers and changes in venographic Marder scores in patients with acute deep vein-thrombosis treated with low-molecular-weight (LMWH) or unfractionated heparin (UFH) has not been reported.


METHODS
We investigated differences in coagulation parameters before and at the end of a twelve days the treatment of patients with an improvement versus no improvement of the venographic findings at the end of the treatment with LMWH (n = 48) and UFH (n = 41).


RESULTS
Patients with lower values in the Marder score had lower D-dimer levels at day 12 compared to entry treated with UFH and LMWH (p < 0.001). Not improved Marder scores paralleled unchanged D-dimer levels at end of both treatments. Higher values of factor-Xa inhibition and Heptest assay (p < 0.001) were measured at the end of treatment in LMWH- in contrast to UFH-patients. Thrombin inhibition was lower and unchanged at day 12 in patients treated with LMWH and UFH, respectively. Thrombin generation inhibition and release of tissue-factor pathway inhibitor remained unchanged in both groups.


CONCLUSIONS
An improved Marder score is associated with a decrease of D-dimer during UFH and LMWH treatment of deep vein-thrombosis.
Harenberg
Job
J
Forth Department of Medicine, University Hospital, Faculty of Clinical Medicine Mannheim of the Ruprecht-Karls, University of Heidelberg, Mannheim, Germany. j-harenberg@t-online.de
Merx
Kirsten
K
Hoffmann
Ursula
U
Tolle
Alexander R
AR
Huisman
Menno V
MV
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000097:blood* / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001779:Blood Coagulation Factors / Q000378:metabolism; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006495:Heparin, Low-Molecular-Weight / Q000097:blood / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D020246:Venous Thrombosis / Q000097:blood* / Q000188:drug therapy
D000925:Anticoagulants; D015415:Biomarkers; D001779:Blood Coagulation Factors; D005338:Fibrin Fibrinogen Degradation Products; D006495:Heparin, Low-Molecular-Weight; C036309:fibrin fragment D