Abstract |
The Prolong study shows that continuing vitamin K antagonists (VKA) in patients with abnormal D-dimer (evaluated by a qualitative assay, Clearview Simplify D-dimer) results in a significant reduction of venous thromboembolism (VTE) recurrence. The present study retrospectively analyzes a subgroup of patients enrolled in the Prolong study with a view to calculate cut-off values for six quantitative D-dimer methods to predict the risk of VTE recurrence. We measured D-dimer levels by VIDAS D-dimer Exclusion (bioMerieux), STA Liatest D-dimer (DiagnosticaStago), HemosIL D-dimer and HemosIL D-dimer HS (Instrumentation Laboratory), Innovance D-dimer (Siemens) and AutoDimer (Trinity Biotech) in frozen plasma aliquots sampled 30 ± 10 days after VKA cessation in 390 patients enrolled in the Prolong study. During follow-up (562.7 years), 28 patients had recurrent VTE (7.2%, 5.0% person-years). Since D-dimer levels are positively correlated with age and significantly lower in men, we calculated method-specific cut-off values according to age and gender. The HRs for VTE recurrence calculated using method-specific cut-off values based on age and gender are higher than those using cut-off values indicated by the manufacturers for VTE exclusion in symptomatic outpatients. These data suggest that method-specific cut-off values calculated according to patient age and gender can be more accurate in identifying patients at a higher risk for VTE recurrence. These method-specific cut-off values are being evaluated in the ongoing prospective management multicenter DULCIS study.
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Authors | Cristina Legnani, Michela Cini, Benilde Cosmi, Paolo Carraro, Armando Tripodi, Nicoletta Erba, Gualtiero Palareti |
Journal | Internal and emergency medicine
(Intern Emerg Med)
Vol. 8
Issue 3
Pg. 229-36
(Apr 2013)
ISSN: 1970-9366 [Electronic] Italy |
PMID | 21584847
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Fibrin Fibrinogen Degradation Products
- Fibrinolytic Agents
- fibrin fragment D
- Vitamin K
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Topics |
- Adult
- Age Factors
- Aged
- Aged, 80 and over
- Female
- Fibrin Fibrinogen Degradation Products
(metabolism)
- Fibrinolytic Agents
- Humans
- Male
- Middle Aged
- Predictive Value of Tests
- Recurrence
- Retrospective Studies
- Risk Factors
- Sex Factors
- Venous Thromboembolism
(blood, drug therapy, etiology)
- Vitamin K
(antagonists & inhibitors)
- Young Adult
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