Elevated d-dimer levels predict recurrence in patients with idiopathic venous thromboembolism: a meta-analysis

Bruinstroop, Eveline; Klok, Frederikus A.; Ree, Marcel A. van de; Oosterwijk, F. L.; Huisman, Menno V.

doi:10.1111/j.1538-7836.2009.03293.x

Cited by 87 publications

(49 citation statements)

References 33 publications

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“…Elevated D-dimer levels give a 2AE4 increase of the recurrence risk in patients with an unprovoked DVT (Bruinstroop et al, 2009). An advantage of D-dimer testing is the simple and standardized technique.…”

Section: Discussionmentioning

confidence: 99%

Residual venous thrombosis as predictive factor for recurrent venous thromboembolim in patients with proximal deep vein thrombosis: a sytematic review

et al. 2011

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Summary The potential role of the detection of residual thrombosis after deep vein thrombosis (DVT) in the differentiation of patients at risk for recurrent venous thromboembolism (VTE) has not yet been fully established and includes different definitions. We performed a systematic review in order to determine the role of residual thrombosis in predicting recurrent VTE after acute proximal DVT. Databases were searched until June 2010. Randomized, controlled trials or prospective cohort studies were eligible for inclusion if they included patients with objectively diagnosed proximal DVT, measured thrombus diameter after at least 3 months and reported recurrent VTE during follow‐up. Two authors independently reviewed articles and extracted data. Data from 11 studies were used for the current analysis; in total 3203 patients were included. Residual thrombosis was positively correlated with recurrent VTE. Large heterogeneity was present, due to differences in study population, timing and the differences in method of measuring residual thrombosis. The effect was more pronounced in patients with malignancy or was dependent on the criteria used. This systematic review shows a positive relationship between residual thrombosis and recurrent VTE during follow‐up. Assessing residual thrombosis could be useful in individual recurrence risk estimation.

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Section: Discussionmentioning

confidence: 99%

Residual venous thrombosis as predictive factor for recurrent venous thromboembolim in patients with proximal deep vein thrombosis: a sytematic review

et al. 2011

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“…Several risk factors for VTE recurrence have been identified, including advanced age [3], male gender [7,8], unprovoked VTE [3,9,10], thrombophilia [3], obesity [11], and persistent elevation of D-dimer 1 month after discontinuation of anticoagulation [12,13] and residual thrombosis [14]. In contrast, prolonged oral anticoagulation therapy reduces VTE recurrence [15].…”

Section: Introductionmentioning

confidence: 98%

Pulmonary embolism risk stratification by European Society of Cardiology is associated with recurrent venous thromboembolism: Findings from a long-term follow-up study

Zhang

Zhai

Yang

et al. 2016

International Journal of Cardiology

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“…Two systematic reviews that examined the use of D-dimer measured after discontinuation of anticoagulants for unprovoked VTE reported approximately a doubling of the risk of recurrence for those with a positive D-dimer result compared with those with a negative D-dimer. 71,72 In only one of the studies included in these meta-analyses was D-dimer measurement used to manage patients. The PROLONG study was a multicentre trial of 708 patients with a first unprovoked venous thromboembolic event who had received at least 3 months of oral anticoagulant therapy.…”

Section: D-dimer Testing For Duration Of Anticoagulant Therapymentioning

confidence: 99%

D-Dimer Assays in Diagnosis and Management of Thrombotic and Bleeding Disorders

Bates

2012

Semin Thromb Hemost

100

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).D-dimer is a global indicator of coagulation activation and fibrinolysis and, therefore, an indirect marker of thrombotic activity. This specific cross-linked fibrin degradation product is formed through the sequential action thrombin, activated factor XIII (FXIIIa), and plasmin (►Fig. 1). 1-3 First, thrombin, generated when coagulation is activated, converts fibrinogen to fibrin and activates FXIII. Second, FXIIIa covalently crosslinks D-domains in adjacent fibrin monomers. Third, plasmin (formed on the fibrin surface by plasminogen activation) cleaves substrate fibrin at specific sites, and when it cleaves fibrin cross-linked by FXIIIa, it generates D-dimer. D-dimer is cleared through the kidneys and the reticuloendothelial system and has a plasma half-life of approximately 8 hours. 4 Low levels of D-dimer can be found circulating under normal physiologic conditions, while pathologically elevated levels can be found in any condition associated with enhanced fibrin formation and fibrinolysis (►Table 1). 1-3 The utility of D-dimer measurement has been evaluated in several clinical situations; however, the D-dimer assays have been best validated for the exclusion of venous thromboembolism (VTE) and the diagnosis and monitoring of disseminated intravascular coagulation (DIC). This article will review the available evidence for the utilization of D-dimer antigen measurement in the management of thrombotic and bleeding disorders. Measurement of D-DimerThe presence of D-dimer in plasma can be detected using monoclonal antibodies that recognize an epitope present in FXIIIa-cross-linked fragment D-domain of fibrin but not in fibrinogen degradation products or noncross-linked fibrin degradation products. Many different D-dimer assays have been developed and marketed. All of these tests rely on the use of monoclonal antibodies to detect D-dimer molecules. In general, three techniques are available to assay D-dimer (►Fig. 2). 1-3 These are (1) enzyme-linked immunosorbent assays (ELISAs) that rely on antibody capture and labeling of D-dimer; (2) a whole-blood agglutination assay (SimpliRED, Siemens Healthcare Diagnostics, Newcastle, DE), that uses a bispecific antibody conjugate with binding sites for both D-dimer and a red cell antigen and is performed on whole blood; (3) latex agglutination assays that also use bispecific antibodies with specificity for the latex particle and D-dimer antigen. Earlier latex agglutination assays for D-dimer were qualitative or semiquantitative; however, newer automated, quantitative D-dimer assays (which are immunoturbidometric assays) are performed on routine, automated coagulation instruments. It is important to recognize that results are not comparable between different assays, even between those of similar formats. Potential reasons for the lack of comparable results are listed in ►Table 2. Numeric results of D-dimerAbstract D-dimer is a global indicator of coagulation activation and fibrinolysis and, therefore, an indirect marker of thrombotic activity. The utility of D-dimer measur...

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Elevated d-dimer levels predict recurrence in patients with idiopathic venous thromboembolism: a meta-analysis

Cited by 87 publications

References 33 publications

Residual venous thrombosis as predictive factor for recurrent venous thromboembolim in patients with proximal deep vein thrombosis: a sytematic review

Residual venous thrombosis as predictive factor for recurrent venous thromboembolim in patients with proximal deep vein thrombosis: a sytematic review

Pulmonary embolism risk stratification by European Society of Cardiology is associated with recurrent venous thromboembolism: Findings from a long-term follow-up study

D-Dimer Assays in Diagnosis and Management of Thrombotic and Bleeding Disorders

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