Unprovoked recurrent venous thrombosis: prediction by D-dimer and clinical risk factors

Journal of Thrombosis and Haemostasis : JTH
Trevor BaglinC Baglin

Abstract

The aim of the study was to determine the predictive value of D-dimer measurement for unprovoked recurrent venous thrombosis and the influence of sex, age and type of first event (unprovoked or provoked). Prospective cohort study of 272 patients with a first episode of venous thrombosis that was unprovoked or provoked by a non-surgical trigger. The cumulative rate of unprovoked recurrence in patients with a positive D-dimer was 20% at 5 years [5.5/100 patient-years, 95% confidence interval (CI) 3.7-7.8] and in patients with a negative D-dimer 17% (4.1/100 patient-years, 95% CI 2.3-6.9). The rates are not different (hazard ratio 1.3, 95% CI 0.7-2.5). After adjustment for clinical risk factors a positive D-dimer result was significantly associated with an increased risk of unprovoked recurrent thrombosis (hazard ratio 2.0, 95% CI 1.01-3.9). The strongest indicator of risk of recurrence was male sex (hazard ratio 3.3 unadjusted and 2.9 after adjustment). The only determinant of D-dimer in a linear regression model was age (P < 0.001). The analysis indicates that clinical risk factors confound the association between D-dimer and risk of recurrence and when adjusted for these confounders a positive D-dimer result is significantly as...Continue Reading

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Citations

Oct 29, 2009·Journal of General Internal Medicine·Toshiko UchidaDavid W Baker
Jan 25, 2013·Current Treatment Options in Cardiovascular Medicine·Maura MarcucciJames Douketis
Aug 6, 2013·Current Opinion in Pulmonary Medicine·Daniela Poli, Gualtiero Palareti
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Sep 13, 2015·International Journal of Laboratory Hematology·G PalaretiUNKNOWN DULCIS D-dimer-ULtrasonography in Combination Italian Study Investigators See Appendix
Mar 2, 2010·Journal of the American Medical Directors Association·Barbara J ZarowitzArthur Wheeler
Jan 30, 2009·Journal of Thrombosis and Haemostasis : JTH·E BruinstroopM V Huisman
Feb 3, 2009·British Journal of Haematology·Sergio SiragusaAlessandra Malato
Jun 23, 2011·International Journal of Laboratory Hematology·Trevor Baglin
Dec 1, 2009·Journal of Thrombosis and Haemostasis : JTH·T Baglin
Feb 7, 2017·Journal of Thrombosis and Haemostasis : JTH·E BjøriS K Braekkan
Sep 27, 2018·Expert Review of Hematology·Gualtiero Palareti, Daniela Poli
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May 3, 2021·European Journal of Internal Medicine·Matteo Nicola Dario Di MinnoPasquale Ambrosino

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