D-dimer level is associated with the extent of pulmonary embolism

Ghanima, Waleed; Abdelnoor, Michael; Holmen, Lars Olaf; Nielssen, Bjørn Einar; Ross, Stephanie; Sandset, Per Morten

doi:10.1016/j.thromres.2006.08.006

Cited by 79 publications

(58 citation statements)

References 25 publications

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“…In patients with pulmonary embolism, the D‐dimer concentration is related to thrombus volume assessed by contrast‐enhanced CT,29 and a high D‐dimer concentration of >5000 ng/mL is a risk factor for in‐hospital mortality 30. Similarly, in patients with deep vein thrombosis, the ultrasound‐based estimated thrombus volume correlates with the D‐dimer concentration 31.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Treatment Outcomes of Acute Type A Aortic Dissection With Elevated D‐Dimer Concentration

Itagaki

Kimura

Mieno

et al. 2018

JAHA

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BackgroundClinical characteristics and treatment outcomes of acute type A aortic dissection with D‐dimer elevation have not been clarified.Methods and ResultsD‐dimer was measured preoperatively within 24 hours of symptom onset in 262 patients with acute type A aortic dissection. The median (and interquartile range) admission D‐dimer concentration in our total patient group was 26.7 (8.3–85.9) μg/mL. Median (interquartile range) D‐dimer concentrations were 5.0 (2.6–18.0) μg/mL for complete false lumen thrombosis (n=33), 60.9 (19.4–160.4) μg/mL for partial thrombosis (n=81), 26.5 (10.0–70.6) μg/mL for a patent false lumen (n=131), and 8.7 (3.2–26.9) μg/mL for ulcerlike projection (n=17) (P<0.01). With a D‐dimer concentration of ≤8.3 μg/mL representing the lower quartile, we then investigated predictors of a low D‐dimer level. Multivariate analysis showed dissection limited to the ascending aorta (P<0.01; odds ratio, 9.81) or descending aorta (P<0.01; odds ratio, 7.68), a completely thrombosed false lumen (P<0.01; odds ratio, 4.02), and absence of brain ischemia (P=0.013; odds ratio, 4.74) to be predictors of the lower D‐dimer concentration. Compared with patients with a low D‐dimer concentration (≤8.3 μg/mL, n=66), patients with a D‐dimer concentration >8.3 μg/mL (n=196) had a reduced preoperative platelet count and increased operation time and transfusion volume. In‐hospital mortality was elevated in this group (1.5% versus 11.2%; P=0.031), although 7‐year survival did not differ for hospital survivors (lower versus higher, 93.1% versus 79.1%; P=0.21).ConclusionsD‐dimer concentrations are strongly influenced by the extent of dissection and false lumen status. Operative risks are increased in patients with a relatively high D‐dimer concentration.

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Section: Discussionmentioning

confidence: 99%

Characteristics and Treatment Outcomes of Acute Type A Aortic Dissection With Elevated D‐Dimer Concentration

Itagaki

Kimura

Mieno

et al. 2018

JAHA

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“…Two radiological characteristics have been shown to be associated with poor outcome and high inhospital mortality: a high pulmonary arterial obstruction index (PAOI) and an increased right ventricle/left ventricle (RV/LV) ratio (7). In a recent study, using these radiologic characteristics Ghanima et al (8) demonstrated that the level of D-dimer is related to the severity of PE.…”

Section: Introductionmentioning

confidence: 99%

Investigation of relationship between the D-dimer and ischemia-modified albumin levels with the radiological imaging-based pulmonary embolism severity score in acute pulmonary embolism

Türedi¹,

Karahan²,

Menteşe³

et al. 2010

Anadolu Kardiyol Derg

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ÖZETAmaç: İki farklı radyolojik parametre, pulmoner arter obstrüksiyon indeksi (PAOI) ve sağ ventrikül/sol ventrikül oranı (RV/LV) temel alınarak, radyolojik görüntüleme-esaslı pulmoner embolizm şiddet skoru ile D-dimer ve iskemi modifiye albümin (IMA) düzeyleri arasındaki muhtemel ilişkiyi incelemek. Yöntemler: Bu prospektif kohort çalışmasında, acil servise başvuran ve spiral bilgisayarlı tomografi (CT) ile PE kesin tanısı konulan kırk yedi hasta çalış-maya dahil edildi. D-dimer ve IMA düzeyleri sırasıyla immuno-turbidimetrik ve kolorimetrik metodlarla belirlendi. Bilgisayarlı tomografi görüntülerinden PAOI ve RV/LV oranları hesaplandı. Biyokimyasal parametrelerin gruplar arasındaki seviyeleri Mann-Whitney U test ve Kruskal-Wallis test kullanılarak karşılaştırıldı ve radyolojik skorlar ile ilişkileri Spearman korelasyon testi kullanılarak belirlendi. Bulgular: Hesaplanan PAOI ve RV/LV oranlarının analizi aralarında belirgin bir ilişki olduğunu yansıttı (r=0.036, p=0.023). PAOI temelinde oluşturulan hafif (< %40), orta (%40 -%60) ve şiddetli (> %60) PE grupları arasında D-dimer düzeyleri göze çarpan oranda farklıydı (p=0.039). Bu fark hafif grup, PAOI< %40, ile şiddetli grup, PAOI> %60 arasındaki D-dimer seviyelerindeki farklılıktan kaynaklanıyordu (p=0.02; Z= -2.328). Aynı zamanda, D-dimer düzeyleri ile PAOI pozitif bir korelasyon gösteriyordu, fakat D-dimer düzeyleri ile RV/LV oranı arasında benzer bir korelasyon yoktu. İskemi modifiye albümin düzeyleri ile D-dimer düzeyleri, PAOI ve RV/LV oranı arasında anlamlı bir korelasyon yoktu. Sonuç: Radyolojik parametreler temelinde PE'nin şiddetinin biyokimyasal olarak belirlenmesinde D-dimer, yeni bir marker olarak önerilen IMA'ya göre daha uygun bir marker olabilir. (Anadolu Kardiyol Derg 2010; 10: 346-52) Anah tar ke li me ler: D-dimer, iskemi modifiye albümin, pulmoner embolizm, pulmoner arter obstrüksiyon indeksi, radyolojik ciddiyet, spiral bilgisayarlı tomografi ABS TRACTObjective: To investigate possible relationship between the D-dimer and ischemia-modified albumin (IMA) levels and radiological imagingbased severity scores in pulmonary embolism (PE) based on two different radiological characteristics; the pulmonary arterial obstruction index (PAOI) and the right ventricle/left ventricle (RV/LV) ratio. Methods: In this prospective cohort study, forty-seven patients presenting to the emergency department and definitively diagnosed with PE using spiral computerized tomography (CT) were initially enrolled in the study. Levels of IMA and D-dimer were assessed colorimetrical and immuno-turbidimetric methods, respectively. The PAOI and RV/LV ratios were calculated from CT images. The levels of biochemical parameters between the groups were compared with use of Mann-Whitney U and Kruskal-Wallis tests and relationship between the radiological scores were assessed using the Spearman correlation test. Results: Analysis of the calculated PAOI and RV/LV ratio revealed a significant correlation between them (r=0.36, p=0.023). D-dimer levels differed considerably among the...

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“…Ancak, PE tanısı almış hastalarda PE şiddeti ile D-dimer arasındaki ilişkiyi inceleyen çalışmalarda çelişkili sonuçlar bildirilmiştir. Ghanima ve ark'ları, Ddimer ile PAOI, RV/LV ve cTnT arasında anlamlı bir ilişki tespit etmişler 70 . Litratürde yapılan başka bir çalışmada, D-dimer'in PE için güçlü bir kısa dönem prognostik belirteç olduğu gösterilmiştir 71 .…”

Section: Diğer Biyobelirteçler Fibrin Yıkım üRünü (D-dimer)unclassified

Pulmoner Embolide Şiddet ve Prognozun Değerlendirilmesi

Kılıç¹

2014

Arşiv Kaynak Tarama Dergisi

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Although technology of diagnosis and treatment continues to improve, the mortality rate of pulmonary embolism remains high. It was detected that more than 10% of the hospital mortality is related to pulmonary embolism. Really, management of this disease is hard. It is a consensus that patients with massif pulmonary embolism, which is characterized hemodynamic impairment, and have indications of aggressive treatments such as thrombolytic. But the issue of treatment of the hemodynamically stable patients with pulmonary embolism accompanied by right ventricular dysfunction is not clear. In last year, because of the cost-effectiveness, it has been reported that lowrisk patients could treated as outpatients. Hence, it is need to make an accurate judgment of pulmonary embolism severity and prognosis. Biomarkers such as brain natriuretic peptide, N-terminal probrain natriuretic peptide, cardiac troponin, and heart-type fatty acid-binding protein are very important indicators of pulmonary embolism severity and short-term prognosis. Furthermore, it was reported that the pulmonary embolism severity index and simplified pulmonary embolism severity index are more suitable assessing the overall mortality and long-term prognosis. It is suggested that they could be used especially in identifying low risk group. In this review, in the recent literature, it will be assessed biomarkers, findings right ventricular dysfunction which were detected by imaging tool, and a few clinical prognostic model for evaluating pulmonary embolism severity and prognosis. Key words: Biomarker; pulmonar mebolis; pulmonary embolism severity index; prognosis; risk evaluation ÖZET Tanı ve tedavideki teknolojik gelişmelere rağmen, pulmoner emboliye bağlı mortalite halen yüksektir. Hastane ölümlerinin %10'dan fazlası pulmoner emboli ile alakalı olduğu tespit edilmiştir. Gerçekten,

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D-dimer level is associated with the extent of pulmonary embolism

Cited by 79 publications

References 25 publications

Characteristics and Treatment Outcomes of Acute Type A Aortic Dissection With Elevated D‐Dimer Concentration

Characteristics and Treatment Outcomes of Acute Type A Aortic Dissection With Elevated D‐Dimer Concentration

Investigation of relationship between the D-dimer and ischemia-modified albumin levels with the radiological imaging-based pulmonary embolism severity score in acute pulmonary embolism

Pulmoner Embolide Şiddet ve Prognozun Değerlendirilmesi

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