Prospective study of plasma D-dimer and incident venous thromboembolism: The Atherosclerosis Risk in Communities (ARIC) Study

Thrombosis Research
Aaron R FolsomM Cushman

Abstract

Plasma D-dimer is a useful clinical test for acute venous thromboembolism (VTE), and concentrations remain higher in VTE patients after treatment than in controls. Yet, evidence is limited on whether higher basal D-dimer concentrations in the general population are associated with greater risk of first VTE. To assess the prospective association between D-dimer and incident VTE over a long follow-up. We measured plasma D-dimer in 12,097 participants, initially free of VTE, in the Atherosclerosis Risk in Communities Study. Over a median follow-up of 17years, we identified 521 VTEs. We calculated hazard ratios of VTE using proportional hazards regression. The age, race, and sex adjusted hazard ratios of VTE across quintiles of D-dimer were 1, 1.5, 1.8, 2.1, and 3.2 (p for trend <0.0001). For the first 10years of follow-up, the hazard ratio for the highest versus lowest quintile was 3.5, and was 2.9 after 10years. In both whites and African Americans, VTE risk remained strongly associated with D-dimer after further adjustment for diabetes, body mass index, kidney function, and several thrombophilia genetic markers. D-dimer was associated with both unprovoked and provoked VTE, but more strongly with unprovoked. A higher basal level ...Continue Reading

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Citations

Jan 5, 2016·European Heart Journal·Victor AboyansUNKNOWN ESC Working Group on Peripheral Circulation
Apr 24, 2016·The Veterinary Journal·Unity JefferyDana LeVine
Mar 13, 2016·Blood·Rakhi P NaikAlexander P Reiner
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Feb 26, 2019·Journal of Thrombosis and Haemostasis : JTH·Antonio P Arenas de LarrivaAaron R Folsom
Nov 5, 2019·Journal of Thrombosis and Haemostasis : JTH·Weihong TangNathan Pankratz
Jun 5, 2020·Circulation Research·Lindsay Fernández-RhodesKari E North
Jul 27, 2018·Research and Practice in Thrombosis and Haemostasis·Mary CushmanRandall S Stafford
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