High circulating D-dimers are associated with ascites and hepatocellular carcinoma in liver cirrhosis.
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.
Spadaro
Aldo
A
Department of Medicine and Pharmacology, Clinica Medica, Pad C-University Hospital, Via Consolare Valeria, Messina 98125, Italy. aldo.spadaro@unime.it
Tortorella
Vincenza
V
Morace
Carmela
C
Fortiguerra
Agostino
A
Composto
Paola
P
Bonfiglio
Caterina
C
Alibrandi
Angela
A
Luigiano
Carmelo
C
De Caro
Giuseppe
G
Ajello
Antonino
A
Ferrau
Oscar
O
Freni
Maria-Antonietta
MA
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
D004232:Diuretics; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D