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Effect of low‐dose warfarin on D‐dimer levels during sickle cell vaso‐occlusive crisis: a brief report
Author(s) -
Ahmed Shahid,
Siddiqui Anita K.,
Iqbal Uzma,
Sison Cristina P.,
Shahid Rabia K.,
Sheth Manish,
Patel Dilip V.,
Russo Linda A.
Publication year - 2004
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.0902-4441.2003.00209.x
Subject(s) - d dimer , medicine , warfarin , hemoglobin , fibrinogen , gastroenterology , white blood cell , sickle cell anemia , surgery , anesthesia , atrial fibrillation , disease
Objective : To evaluate the activation of clotting systems in patients with sickle cell disease (SCD) by measuring the plasma D‐dimer level and to determine the effect of low‐dose warfarin on D‐dimer level during vaso‐occlusive crisis. Methods : Plasma D‐dimer level was measured in 65 blood samples of 37 adult patients with SCD who were hospitalized for vaso‐occlusive painful crisis. D‐dimer level of patients who were on low‐dose warfarin was compared with those patients who were not on any anticoagulation treatment. Analysis of variance ( anova ) was carried out to determine factors significantly associated with low D‐dimer level in patients with SCD. The following factors were included in the anova model; warfarin, homozygous hemoglobin S, history of blood transfusion in past 3 months, hydroxyurea, hemoglobin S%, hemoglobin F%, white blood cell counts, hemoglobin level, platelet count, and plasma fibrinogen level. Results : Overall median D‐dimer level in 65 samples was 2.7 μ g fibrinogen equivalent units (FEU)/mL (0.34–4). Patients who were on low‐dose warfarin had a median D‐dimer level of 0.81 μ g FEU/mL (0.34–1.8) compared with 3.1 μ g FEU/mL (0.94–4) in those patients who were not on anticoagulation treatment. Using anova to model D‐dimer levels, only warfarin was significantly correlated with low D‐dimer levels after controlling for other variables. Conclusions : Patients with SCD during vaso‐occulsive painful crisis have an elevated D‐dimer level. Low‐dose anticoagulation treatment is associated with a significant reduction in the D‐dimer levels.