title: High circulating D-dimers are associated with ascites and hepatocellular carcinoma in liver cirrhosis.
abstract: OBJECTIVE
  To measure plasma D-dimer levels in cirrhotic patients with and without ascites, assessing the effect of ascites resolution in D-dimer concentration.
  
  
  METHODS
  Seventy consecutive cirrhotic patients (M = 44, F = 26, mean age 65 years, SD +/- 13), observed from October 2005 to March 2006 were enrolled. Circulating D-dimer levels were measured using a latex-enhanced, immunoturbidimetric test. In patients with ascites (n = 42) the test was repeated after ascites resolution.
  
  
  RESULTS
  Ascites was present in 42 patients (group A) and absent in 28 (group B). Group A patients had more advanced liver disease. Hepatocellular carcinoma (HCC) was diagnosed in 14 patients and was more frequent in group B. Above normal range D-dimers were found in 45/70 patients. High D-dimers were more frequent in group A than in group B (P = 0.001). High D-dimers were associated with presence of HCC (P = 0.048) only in group B. After ascites resolution, obtained in all patients, mean D-dimer values decreased in those 34 patients with high basal levels (P = 0.007), returning to normal in 17.
  
  
  CONCLUSIONS
  In patients with liver cirrhosis, ascites and HCC are the main factors associated with increased fibrinolytic activity.
authors.affiliation: Department of Medicine and Pharmacology, Clinica Medica, Pad C-University Hospital, Via Consolare Valeria, Messina 98125, Italy. aldo.spadaro@unime.it
authors.forename: Aldo
authors.initials: A
authors.lastname: Spadaro
authors.forename: Vincenza
authors.initials: V
authors.lastname: Tortorella
authors.forename: Carmela
authors.initials: C
authors.lastname: Morace
authors.forename: Agostino
authors.initials: A
authors.lastname: Fortiguerra
authors.forename: Paola
authors.initials: P
authors.lastname: Composto
authors.forename: Caterina
authors.initials: C
authors.lastname: Bonfiglio
authors.forename: Angela
authors.initials: A
authors.lastname: Alibrandi
authors.forename: Carmelo
authors.initials: C
authors.lastname: Luigiano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Caro
authors.forename: Antonino
authors.initials: A
authors.lastname: Ajello
authors.forename: Oscar
authors.initials: O
authors.lastname: Ferrau
authors.forename: Maria-Antonietta
authors.initials: MA
authors.lastname: Freni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000097:blood* / Q000209:etiology / Q000628:therapy; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000209:etiology; D004039:Diet, Sodium-Restricted; D018450:Disease Progression; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications; D008113:Liver Neoplasms / Q000097:blood* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D019152:Paracentesis
chemical_list: D004232:Diuretics; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D