Document Detail


D-dimers, thrombin-antithrombin complexes, and risk factors for thromboembolism in hospitalized patient.
MedLine Citation:
PMID:  18796458     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: There is lack of data about the correlation between hemostatic markers and the clinical and biological risk factors (RFs) for venous thromboembolism (VTE) in medical inpatients without suspicion of acute VTE. MATERIAL AND METHODS: To evaluate the coagulation activation status in patients with current known RFs for VTE, the authors measured 2 markers of hypercoagulability, thrombin antithrombin (TAT) complexes and D-dimers, at day 1 in 165 patients hospitalized in internal medicine wards without suspected acute VTE. All known RFs for VTE were systematically assessed at admission and classified in a chronological way as permanent or transient. RESULTS: Surprisingly, TAT values followed a multimodal distribution. D-dimers showed a normal distribution after a logarithmic transformation (P = .34, Shapiro-Wilk test). Interestingly, a significant progression in D-dimer levels was found according to the chronological classification of RFs. D-dimer variations on multivariate analysis (not applicable for TAT because of the multimodal distribution) correlated independently with a recent inability to walk and an increase in C reactive protein level more than 10 mg/L. CONCLUSIONS: (a) this study is the first to describe the variations of hypercoagulability markers according to a systematic screening of RFs for VTE in inpatients without suspicion of acute VTE, (b) TAT appeared as a less relevant marker of hypercoagulability than D-dimers in internal medicine inpatients, (d) the chronological classification of RFs identified clearly groups at risk for the prethrombotic state, and (d) an increased hypercoagulability state was demonstrated in patients with an association between a recent immobility and increased inflammatory markers.
Authors:
Pierre Pottier; Marc Fouassier; Jean-Benoit Hardouin; Christelle Volteau; Bernard Planchon
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-09-15
Journal Detail:
Title:  Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis     Volume:  15     ISSN:  1938-2723     ISO Abbreviation:  Clin. Appl. Thromb. Hemost.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-20     Completed Date:  2010-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9508125     Medline TA:  Clin Appl Thromb Hemost     Country:  United States    
Other Details:
Languages:  eng     Pagination:  666-75     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Nantes University-Hospital Centre, Nantes, France. pierre.pottier@univ-nantes.fr
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MeSH Terms
Descriptor/Qualifier:
Antithrombin III
Biological Markers / blood
C-Reactive Protein / analysis
Female
Fibrin Fibrinogen Degradation Products / analysis*
Hemostasis
Humans
Inflammation / blood
Inpatients
Male
Middle Aged
Multivariate Analysis
Normal Distribution
Paresis
Peptide Hydrolases / blood*
Risk Factors
Thromboembolism / blood*
Thrombophilia / blood,  diagnosis
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Fibrin Fibrinogen Degradation Products; 0/antithrombin III-protease complex; 0/fibrin fragment D; 9000-94-6/Antithrombin III; 9007-41-4/C-Reactive Protein; EC 3.4.-/Peptide Hydrolases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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