D-dimer testing in survivors of venous thromboembolism may be helpful in predicting the risk of its recurrence
Journal Title: Polski Przegląd Kardiologiczny - Year 2008, Vol 10, Issue 1
Abstract
D-dimer is a product of cross-linked fibrin degradation. D-dimer concentration is a marker of coagulation - fibrinolysis balance. Elevated D-dimer concentration reflects increased coagulation activity in the presence of normal or elevated fibrinolytic activity. D-dimer assessment is useful in ruling out suspected acute venous thromboembolism. Recently few studies concerning D-dimer concentration in patients after deepyenous thrombosis or acute pulmonary embolism have appeared. Elevated D-dimer after longterm sufficient anticoagulation reflects persistent coagulation - fibrinolysis imbalance and may be helpful in predicting incomplete recanalization of pulmonary circulation and deep veins or in predicting venous thromboembolism recurrence. Current observations suggest that venous thromboembolism especially idiopathic should be considered chronic disease. Secondary prophylaxis duration should be tailored to individual patient not only with known risk factors of thrombosis as well as bleeding but D-dimer concentration after acute phase should also be taken into account. Until now cut-off point for D-dimer in assessment of recurrentyenous thromboembolism risk after discontinuation of anticoagulant treatment is not established. lt seems reason able to apply in this situation cut-off point of 500 ng/ml, which was validated in diagnostic algorithm of venous thrombosis and acute pulmonary embolism.
Authors and Affiliations
Anna Kaczyńska, Piotr Pruszczyk
Keywords
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