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D-dimer levels and risk of recurrence following provoked venous thromboembolism: findings from the RIETE registry.
- Source :
- Journal of Internal Medicine; Jan2020, Vol. 287 Issue 1, p32-41, 10p, 4 Charts
- Publication Year :
- 2020
-
Abstract
- <bold>Background: </bold>Patients with venous thromboembolism (VTE) secondary to transient risk factors may develop VTE recurrences after discontinuing anticoagulation. Identifying at-risk patients could help to guide the duration of therapy.<bold>Methods: </bold>We used the RIETE database to assess the prognostic value of d-dimer testing after discontinuing anticoagulation to identify patients at increased risk for recurrences. Transient risk factors were classified as major (postoperative) or minor (pregnancy, oestrogen use, immobilization or recent travel).<bold>Results: </bold>In December 2018, 1655 VTE patients with transient risk factors (major 460, minor 1195) underwent d-dimer measurements after discontinuing anticoagulation. Amongst patients with major risk factors, the recurrence rate was 5.74 (95% CI: 3.19-9.57) events per 100 patient-years in those with raised d-dimer levels and 2.68 (95% CI: 1.45-4.56) in those with normal levels. Amongst patients with minor risk factors, the rates were 7.79 (95% CI: 5.71-10.4) and 3.34 (95% CI: 2.39-4.53), respectively. Patients with major risk factors and raised d-dimer levels (n = 171) had a nonsignificantly higher rate of recurrences (hazard ratio [HR]: 2.14; 95% CI: 0.96-4.79) than those with normal levels. Patients with minor risk factors and raised d-dimer levels (n = 382) had a higher rate of recurrences (HR: 2.34; 95% CI: 1.51-3.63) than those with normal levels. On multivariate analysis, raised d-dimers (HR: 1.74; 95% CI: 1.09-2.77) were associated with an increased risk for recurrences in patients with minor risk factors, not in those with major risk factors.<bold>Conclusions: </bold>Patients with raised d-dimer levels after discontinuing anticoagulant therapy for VTE provoked by a minor transient risk factor were at an increased risk for recurrences. [ABSTRACT FROM AUTHOR]
- Subjects :
- THROMBOEMBOLISM
FIBRIN fragment D
MULTIVARIATE analysis
Subjects
Details
- Language :
- English
- ISSN :
- 09546820
- Volume :
- 287
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Journal of Internal Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 140455057
- Full Text :
- https://doi.org/10.1111/joim.12969