D-Dimer is a Predictive Factor of Cancer Therapeutics-Related Cardiac Dysfunction in Patients Treated With Cardiotoxic Chemotherapy

Abstract

Background: D-dimer is a sensitive biomarker for cancer-associated thrombosis, but little is known about its significance on cancer therapeutics-related cardiac dysfunction (CTRCD). Methods: Consecutive 169 patients planned for cardiotoxic chemotherapy were enrolled and followed up for 12 months. All patients underwent echocardiography and blood test at baseline, as well as at 3-month, 6-month, and 12-month. Results: The patients were divided into 2 groups based on the level of D-dimer (> 1.65 µg/ml or ≦ 1.65 µg/ml) at baseline before chemotherapy: High D-dimer group (n = 37) and low D-dimer group (n = 132). Left ventricular ejection fraction (EF) decreased at 3-month and 6-month after chemotherapy in high D-dimer group (baseline, 65.2% [62.8%-71.4%]; 3-month, 62.9% [59.0%-67.7%]; 6-month, 63.1% [60.0%-67.1%]; 12-month, 63.3% [58.8%-66.0%], P = 0.03), but no change was observed in low D-dimer group. The occurrence of CTRCD within the 12-month follow-up period was higher in high D-dimer group than in low D-dimer group (16.2% vs. 4.5%, P = 0.0146). Multivariable logistic regression analysis revealed that high D-dimer level at baseline was an independent predictor of the development of CTRCD (odds ratio 3.93, 95% CI [1.00-15.82], P = 0.047). Conclusion: Elevated D-dimer is a pivotal biomarker to predict CTRCD.

Prognostic value of plasma D-dimer levels in advanced non-small cell lung cancer patients treated with immune checkpoint inhibitors: a retrospective study

“…Plasma D-dimer, the smallest cross-linked protein produced in the proteolytic process, is a marker for detecting malignancy and is of great significance for the clinical exclusion of tumor-related thrombosis (21). Previous studies have shown the predictive role of plasma D-dimer in many malignancies treated with chemotherapy, including lung cancer (22)(23)(24)(25)(26), colorectal cancer (27), gallbladder carcinoma (20), and breast cancer (28). However, whether pretreatment D-dimer can predict therapeutic efficacy and prognosis in advanced NSCLC patients receiving ICI treatment remains unclear.…”