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High D ‐dimer levels at presentation in patients with venous thromboembolism is a marker of adverse clinical outcomes
Author(s) -
Paneesha S.,
Cheyne E.,
French K.,
Bacchu S.,
Borg A.,
Rose P.
Publication year - 2006
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2006.06260.x
Subject(s) - malignancy , medicine , d dimer , presentation (obstetrics) , venous thromboembolism , gastroenterology , surgery , thrombosis
Summary Qualitative d ‐dimer results, together with clinical probability scores, are well established in the diagnosis of venous thromboembolism (VTE). The predictive value of quantitative d ‐dimer levels for various clinical outcomes in VTE patients is not fully understood. d ‐dimer levels obtained at presentation were analysed in 699 (360 men; 339 women) VTE patients for survival and occurrence of malignancy. Patients were followed for a median of 23 months. 17·2% patients had a d ‐dimer level >8000 ng FEU/mlat presentation, which was associated with decreased overall survival (OS) ( P < 0·001) and event‐free survival (EFS) ( P < 0·001). 25·4% patients had malignancy and 4% subsequently developed malignancy following VTE. 29·9% of patients with VTE and malignancy had a d ‐dimer level >8 mg/l when compared with 13·4% of patients with VTE without malignancy ( P < 0·001). 50% of patients who developed subsequent malignancy following VTE had a presentation d ‐dimer >8000 ng FEU/mlas compared with 13·3% of patients with VTE with out malignancy ( P = 0·009). In conclusion, d ‐dimer >8000 ng FEU/ml at presentation in patients with VTE is a marker of poor OS, EFS and underlying malignancy. Consideration of screening for malignancy is recommended in patients with VTE with a presentation d ‐dimer >8000 ng FEU/ml and age >60 years.