title: Association of changes in D-dimer and other coagulation markers with changes in Marder score after treatment of acute venous thrombosis.
abstract: 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.
authors.affiliation: 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
authors.forename: Job
authors.initials: J
authors.lastname: Harenberg
authors.forename: Kirsten
authors.initials: K
authors.lastname: Merx
authors.forename: Ursula
authors.initials: U
authors.lastname: Hoffmann
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Tolle
authors.forename: Menno V
authors.initials: MV
authors.lastname: Huisman
mesh_terms: 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
chemical_list: D000925:Anticoagulants; D015415:Biomarkers; D001779:Blood Coagulation Factors; D005338:Fibrin Fibrinogen Degradation Products; D006495:Heparin, Low-Molecular-Weight; C036309:fibrin fragment D