D-Dimer and thrombus burden in acute pulmonary embolism

Keller, Karsten; Beule, Johannes; Balzer, J. O.; Dippold, Wolfgang

doi:10.1016/j.ajem.2018.01.048

Cited by 39 publications

(33 citation statements)

References 36 publications

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“…In this study, because the prognostic value did not alter even after adjusting for various confounders such as age, sex, BMI, vascular risk factors, baseline NIHSS scores, and stroke etiology, our results revealed plasma D-dimer levels are an independent biological prognostic marker of AIS. In fact, the positive value of plasma D-dimer in patients with all subtypes of AIS was indicated in several previous studies [33, 41, 42], which is consistent with our findings.…”

Section: Discussionsupporting

confidence: 93%

“…D-dimer derived from the cross-linked fibrin network is a final soluble fibrin degradation product which undergoes plasmin-mediated degradation [13]. Plasma D-dimer could be elevated in a population with thrombotic diseases such as pulmonary embolism and venous thromboembolism [42, 43], however, the mechanism remains unclear. There are several possible explanations for why plasma D-dimer levels might be relevant to poor functional outcome in patients with AIS.…”

Section: Discussionmentioning

confidence: 99%

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Elevated plasma D-dimer levels are associated with short-term poor outcome in patients with acute ischemic stroke: a prospective, observational study

Yao

Tian

et al. 2019

BMC Neurol

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Background Elevated levels of plasma D-dimer increase the risk of ischemic stroke, stroke severity, and the progression of stroke status, but the association between plasma D-dimer level and functional outcome is unclear. The aim of this study is to investigate whether plasma D-dimer level is a determinant of short-term poor functional outcome in patients with acute ischemic stroke (AIS). Methods This prospective study included 877 Chinese patients with AIS admitted to Renmin Hospital of Wuhan University within 72 h of symptom onset. Patients were categorized by plasma D-dimer level: Quartile 1(≤0.24 mg/L), Quartile 2 (0.25–0.56 mg/L), Quartile 3 (0.57–1.78 mg/L), and Quartile 4 (> 1.78 mg/L). The medical record of each patient was reviewed, and demographic, clinical, laboratory and neuroimaging information was abstracted. Functional outcome at 90 days was assessed with the modified Rankin Scale. Results Poor outcome was present in 302 (34.4%) of the 877 patients that were included in the study (mean age, 64 years; male, 68.5%). After adjustment for potential confounding variables, higher plasma D-dimer level on admission was associated with poor outcome (adjusted odds ratio 2.257, 95% confidence interval 1.349–3.777 for Q4:Q1; P trend = 0.004). According to receiver operating characteristic (ROC) analysis, the best discriminating factor for poor outcome was a plasma D-dimer level ≥ 0.315 mg/L (area under the ROC curve 0.657; sensitivity 83.8%; specificity 41.4%). Conclusion Elevated plasma D-dimer levels on admission are significantly associated with poor outcome after admission for AIS, suggesting the potential role of plasma D-dimer level as a predictive marker for short-term poor outcome in patients with AIS.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Elevated plasma D-dimer levels are associated with short-term poor outcome in patients with acute ischemic stroke: a prospective, observational study

Yao

Tian

et al. 2019

BMC Neurol

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“…Biomarkers such as CRP and D-dimer levels were close related to severity of CAP [4,22,23,27] . Plasma D-dimer is a degradation product of cross-linked fibrin and D-dimer values are elevated in the presence of acute clots [28] . In our study, D-dimer was 11.1±12.4 mg/L and it was higher than 5.0 mg/L in 58.1% of patients, which suggested D-dimer > 5.0 mg/L, particularly > 11.1 mg/L would help the early diagnosis of thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Mycoplasma pneumoniae pneumonia associated thrombosis at Beijing Children’s Hospital

Liu

et al. 2020

Preprint

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Background: With the increase of awareness of mycoplasma pneumoniae pneumonia (MPP), we found thrombosis in severe MPP (SMPP) was not rare. The aim of the study was to investigate the clinical characteristics, treatment, and long-term prognosis of MPP-associated thrombosis. Methods: We retrospectively reviewed the medical records of 43 children with MPP-associated thrombosis between January 2013 and June 2019 at Beijing Children’s Hospital. The results of blood coagulation studies, autoimmune antibody, thrombophilia screening, contrast-enhanced lung computed tomography, echocardiography, and blood vessel ultrasonography were analyzed, as were treatment outcomes. Results: Forty-two patients were diagnosed with SMPP. D-dimer was higher than 5.0 mg/L in 58.1% (25/43) of patients. The mean D-dimer level was 11.1 ± 12.4 mg/L. Anticardiolipin-IgM was positive in 60.0% of patients, β2-glycoprotein-IgM in 64.0%, and lupus anticoagulant in 42.1%. Chest imaging revealed pulmonary consolidation with lobe distribution in all patients (2/3–1 lobe in 10 patients, > 1 lobe in 29 patients). In our experience, thrombosis can occur in a vessel of any part of the body, and it can be initially detected as late as 31 days after disease onset. Thrombosis in the brain and abdomen can occur early, at 5 days after disease onset. Pulmonary vessels were the most commonly involved sites in the current study, and accordingly chest pain was the most common symptom (32.6%), followed by neurological symptoms (14.0%) and abdominal pain (9.3%). Thirty-five percent of patients were asymptomatic with regard to thrombosis. All patients underwent anticoagulant therapy, and thrombus absorption took > 3 months in most patients. All patients were followed until October 2019, at which time 41 were asymptomatic and 2 had mild recurrent cough. Conclusions: SMPP with pulmonary consolidation (> 2/3 lobe) was the most strongly associated risk factor for thrombosis. Thrombosis-associated symptoms may be subtle, even absent. Elevated D-dimer, specifically > 11.1 mg/L (even > 5.0mg/L), would assist in the early diagnosis of thrombosis. The long-term prognosis of thrombosis was good after timely administration of anticoagulant therapy.

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“…Biomarkers such as CRP and D-dimer levels were close related to severity of CAP [4,22,23,27] . Plasma D-dimer is a degradation product of cross-linked fibrin and D-dimer values are elevated in the presence of acute clots [28] . In our study, D-dimer was 11.1±12.4 mg/L, which suggested D-dimer >11.1 mg/L would help the early diagnosis of thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Mycoplasma pneumoniae pneumonia associated thrombosis at Beijing Children’s Hospital

Liu

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: With the increase of awareness of mycoplasma pneumoniae pneumonia (MPP), we found thrombosis in severe MPP (SMPP) was not rare. The aim of the study was to investigate the clinical characteristics, treatment, and long-term prognosis of MPP-associated thrombosis. Methods: Data from 43 cases of MPP-associated thrombosis were retrospectively analyzed. The results of blood coagulation studies and autoimmune antibody and thrombophilia screening were analyzed. The results of contrast-enhanced lung computed tomography, echocardiography, and blood vessel ultrasonography were analyzed, as were treatment outcomes. Results: Forty-two patients were diagnosed with SMPP. The mean D-dimer level was 11.1 ± 12.4 mg/L. Anticardiolipin-IgM was positive in 60.0% of patients, β2-glycoprotein-IgM in 64.0%, and lupus anticoagulant in 42.1%. Chest imaging revealed pulmonary consolidation with lobe distribution in all patients (2/3–1 lobe in 10 patients, > 1 lobe in 29 patients). Thrombosis can occur in a vessel of any part of the body. It can be initially detected as late as 31 days after disease onset. Thrombosis in the brain and abdomen can occur early, at 5 days after disease onset. Pulmonary vessels were the most commonly involved sites in the current study, and accordingly chest pain was the most common symptom (32.6%), followed by neurological symptoms (14.0%) and abdominal pain (9.3%). Thirty-five percent of patients were asymptomatic with regard to thrombosis. All patients underwent anticoagulant therapy, and thrombus absorption took > 3 months in most patients. All patients were followed until October 2019, at which time 41 were asymptomatic and 2 had mild recurrent cough. Conclusions: SMPP with pulmonary consolidation (> 2/3 lobe) was the most strongly associated risk factor for thrombosis. Thrombosis-associated symptoms may be subtle, even absent. Elevated D-dimer, specifically > 11.1 mg/L, would assist in the early diagnosis of thrombosis. The long-term prognosis of thrombosis was good after timely administration of anticoagulant therapy.

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D-Dimer and thrombus burden in acute pulmonary embolism

Cited by 39 publications

References 36 publications

Elevated plasma D-dimer levels are associated with short-term poor outcome in patients with acute ischemic stroke: a prospective, observational study

Elevated plasma D-dimer levels are associated with short-term poor outcome in patients with acute ischemic stroke: a prospective, observational study

Mycoplasma pneumoniae pneumonia associated thrombosis at Beijing Children’s Hospital

Mycoplasma pneumoniae pneumonia associated thrombosis at Beijing Children’s Hospital

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D-Dimer and thrombus burden in acute pulmonary embolism

Cited by 39 publications

References 36 publications

Elevated plasma D-dimer levels are associated with short-term poor outcome in patients with acute ischemic stroke: a prospective, observational study

Elevated plasma D-dimer levels are associated with short-term poor outcome in patients with acute ischemic stroke: a prospective, observational study

Mycoplasma pneumoniae​ pneumonia associated thrombosis at Beijing Children’s Hospital

Mycoplasma pneumoniae​ pneumonia associated thrombosis at Beijing Children’s Hospital

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Product

Resources

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Mycoplasma pneumoniae pneumonia associated thrombosis at Beijing Children’s Hospital

Mycoplasma pneumoniae pneumonia associated thrombosis at Beijing Children’s Hospital