title: D-Dimer elevation and adverse outcomes.
abstract: D-Dimer is a biomarker of fibrin formation and degradation. While a D-dimer within normal limits is used to rule out the diagnosis of deep venous thrombosis and pulmonary embolism among patients with a low clinical probability of venous thromboembolism (VTE), the prognostic association of an elevated D-dimer with adverse outcomes has received far less emphasis. An elevated D-dimer is independently associated with an increased risk for incident VTE, recurrent VTE, and mortality. An elevated D-dimer is an independent correlate of increased mortality and subsequent VTE across a broad variety of disease states. Therefore, medically ill subjects in whom the D-dimer is elevated constitute a high risk subgroup in which the prospective evaluation of the efficacy and safety of antithrombotic therapy is warranted.
authors.affiliation: Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, East Campus, RW 459, Boston, MA, 02215, USA.
authors.forename: Rim
authors.initials: R
authors.lastname: Halaby
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Popma
authors.forename: Ander
authors.initials: A
authors.lastname: Cohen
authors.forename: Gerald
authors.initials: G
authors.lastname: Chi
authors.forename: Marcelo Rodrigues
authors.initials: MR
authors.lastname: Zacarkim
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Romero
authors.forename: Samuel Z
authors.initials: SZ
authors.lastname: Goldhaber
authors.forename: Russell
authors.initials: R
authors.lastname: Hull
authors.forename: Adrian
authors.initials: A
authors.lastname: Hernandez
authors.forename: Robert
authors.initials: R
authors.lastname: Mentz
authors.forename: Robert
authors.initials: R
authors.lastname: Harrington
authors.forename: Gregory
authors.initials: G
authors.lastname: Lip
authors.forename: Frank
authors.initials: F
authors.lastname: Peacock
authors.forename: James
authors.initials: J
authors.lastname: Welker
authors.forename: Ignacio
authors.initials: I
authors.lastname: Martin-Loeches
authors.forename: Yazan
authors.initials: Y
authors.lastname: Daaboul
authors.forename: Serge
authors.initials: S
authors.lastname: Korjian
authors.forename: C Michael
authors.initials: CM
authors.lastname: Gibson
mesh_terms: D015415:Biomarkers / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D054556:Venous Thromboembolism / Q000097:blood* / Q000188:drug therapy / Q000401:mortality*; D020246:Venous Thrombosis / Q000097:blood* / Q000188:drug therapy / Q000401:mortality*
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D005343:Fibrinolytic Agents; C036309:fibrin fragment D