Increased d-dimer levels predict cardiovascular mortality in patients with systolic heart failure

Zorlu, Ali; Yilmaz, Mehmet Birhan; Yücel, Hasan; Bektaşoğlu, Gökhan; Ege, Meltem Refıker; Tandoğan, İzzet

doi:10.1007/s11239-011-0635-0

Cited by 33 publications

(24 citation statements)

References 22 publications

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“…Previous studies reported that Ddimer levels are able to predict deaths in patients with heart failure. 22,23) A similar prognostic value was demonstrated in patients with cancer. 9,24,25) Therefore, D-dimer has the potential to predict all-cause events.…”

Section: D-dimer To Predict Outcomes In Post-mhvr Patientssupporting

confidence: 53%

D-Dimer to Predict the Clinical Outcomes in Patients with Mechanical Heart Valve Replacement During Oral Anticoagulation Therapy

et al. 2019

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Mechanical heart valve replacement (MHVR) entails lifetime oral anticoagulation to eliminate thrombosis. However, adverse events may still occur despite proper anticoagulation therapy. In this study, we investigated whether D-dimer can predict the clinical events in post-MHVR patients during oral anticoagulation therapy. This was a single-center, prospective study. In all, 772 patients who underwent MHVR in the Wuhan Asia Heart Hospital from January 2013 to May 2014 were screened. Patients were assigned to the abnormal D-dimer group and the normal D-dimer group according to the D-dimer levels measured 3 months after the beginning of the oral anticoagulation therapy regime. All patients were followed up for 24 months or until the observation of the endpoints, which included thrombotic events, bleeding events, and all-cause deaths. A total of 718 patients were included in the analysis: 91 had abnormal D-dimer levels, and 627 had normal D-dimer levels. In all, 53 events were observed during 24 months. Compared with the normal D-dimer group, patients with abnormal D-dimer levels had a higher incidence of thrombotic events (10 versus 14; hazard

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Section: D-dimer To Predict Outcomes In Post-mhvr Patientssupporting

confidence: 53%

D-Dimer to Predict the Clinical Outcomes in Patients with Mechanical Heart Valve Replacement During Oral Anticoagulation Therapy

et al. 2019

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“…Multivariate regression analysis exhibited that D‐dimer level is an independent predictor of thrombotic events during anticoagulation therapy. Moreover, among patients with heart failure, cancer, and other conditions requiring anticoagulation therapy, the abnormal level of D‐dimer is significantly associated with subsequent deaths, cancer‐related VTE, and other adverse outcomes . In conclusion, D‐dimer can be a useful predictor of all‐cause events during oral anticoagulation therapy.…”

Section: Use Of D‐dimer In Oral Anticoagulation Therapymentioning

confidence: 92%

Use of D‐dimer in oral anticoagulation therapy

Zhang

Long

Xiao

et al. 2018

Int J Lab Hematology

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Individualized anticoagulation management and improvement of the safety and effectiveness of oral anticoagulant have always been the focus of clinicians' attention. D‐dimer, a sensitive marker of thrombosis and coagulation activation, is not only traditionally used in the diagnosis of venous thromboembolism, acute aortic dissection, and disseminated intravascular coagulation but can also be used as a helpful marker in the management of oral anticoagulant, including evaluating the anticoagulation quality, predicting clinical outcomes, and determining the optimal duration and intensity of anticoagulation.

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“…27,28 A study of 174 patients with systolic HF demonstrated that elevated thrombin activity (D-dimer >1435 ng/mL) was associated with greater than threefold increase in mortality. 29 Thus, a growing body of evidence provides the clinical rationale for modulation of thrombin generation in HF-rEF. In contrast, inhibition of Factor Xa with rivaroxaban is associated with an increased risk of bleeding.…”

Section: Thrombosismentioning

confidence: 99%

“…Patients with HF have increased thrombin activity (D‐dimer, thrombin‐antithrombin complexes) compared with controls . A study of 174 patients with systolic HF demonstrated that elevated thrombin activity (D‐dimer >1435 ng/mL) was associated with greater than threefold increase in mortality …”

Section: Introductionmentioning

confidence: 99%

Rationale and design of a randomized, double‐blind, event‐driven, multicentre study comparing the efficacy and safety of oral rivaroxaban with placebo for reducing the risk of death, myocardial infarction or stroke in subjects with heart failure and significant coronary artery disease following an exacerbation of heart failure: the COMMANDER HF trial

Zannad

Greenberg

Cleland

et al. 2015

European J of Heart Fail

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AimsThrombin is a critical element of crosstalk between pathways contributing to worsening of established heart failure (HF). The aim of this study is to explore the efficacy and safety of rivaroxaban 2.5 mg bid compared with placebo (with standard care) after an exacerbation of HF in patients with reduced ejection fraction (HF‐rEF) and documented coronary artery disease.MethodsThis is an international prospective, multicentre, randomized, double‐blind, placebo‐controlled, event‐driven study of approximately 5000 patients for a targeted 984 events. Patients must have a recent symptomatic exacerbation of HF, increased plasma concentrations of natriuretic peptides (B‐type natriuretic peptide ≥200 pg/mL or N‐terminal pro–B‐type natriuretic peptide ≥800 pg/mL), with left ventricular ejection fraction ≤40% and coronary artery disease. Patients requiring anticoagulation for atrial fibrillation or other conditions will be excluded. After an index event (overnight hospitalization, emergency department or observation unit admission, or unscheduled outpatient parenteral treatment for worsening HF), patients will be randomized 1:1 to rivaroxaban or placebo (with standard of care). The primary efficacy outcome event is a composite of all‐cause mortality, myocardial infarction or stroke. The principal safety outcome events are the composite of fatal bleeding or bleeding into a critical space with potential permanent disability, bleeding events requiring hospitalization and major bleeding events according to International Society on Thrombosis and Haemostasis bleeding criteria.Conclusion COMMANDER HF is the first prospective study of a target‐specific oral antithrombotic agent in HF. It will provide important information regarding rivaroxaban use following an HF event in an HF‐rEF patient population with coronary artery disease.

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Increased d-dimer levels predict cardiovascular mortality in patients with systolic heart failure

Cited by 33 publications

References 22 publications

D-Dimer to Predict the Clinical Outcomes in Patients with Mechanical Heart Valve Replacement During Oral Anticoagulation Therapy

D-Dimer to Predict the Clinical Outcomes in Patients with Mechanical Heart Valve Replacement During Oral Anticoagulation Therapy

Use of D‐dimer in oral anticoagulation therapy

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