| Elevated D-dimer concentration identifies patients with incomplete recanalization of pulmonary artery thromboemboli despite 6 months anticoagulation after the first episode of acute pulmonary embolism. | |
| | |
MedLine Citation:
|
PMID: 17931694 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Despite long-term anticoagulation in some patients after acute pulmonary embolism (APE) pulmonary thrombi are not completely resolved. We hypothesized that elevated D-dimer concentration reflecting increased endogenous fibrinolysis may indicate incomplete pulmonary thrombi resolution after the first episode of PE. METHODS: 55 patients aged 54.7+/-18.6 years were anticoagulated for 6 months with acenocumarol (74.5% patients) or low molecular weight heparin (25.5% patients) when control spiral computed tomography (sCT), lung perfusion scintigraphy and D-dimer assessment were performed. RESULTS: Incomplete recanalization of pulmonary circulation was found in 39 (70.9%) patients - thrombi at sCT and/or > or =1 wedge-shaped perfusion defect at scintigraphy. Age, sex, rate of unprovoked APE, malignancies, thrombolysis in the acute phase and type of long-term anticoagulation were similar in patients without and with complete recanalization. D-dimer at follow-up but not on admission was higher in patients with then without incomplete recanalization (median 340 (80-2280) vs 160 (60-390) ng/mL, p=0.02). All 11 (20%) patients with D-dimer level >500 ng/mL at follow-up did not resolve thromboemboli completely. ROC analysis showed that D-dimer at follow-up identified patients with incomplete recanalization (AUC 0.709, 95% CI (0.560-0.831), p=0.007). Multivariable analysis confirmed that D-dimer >350 ng/mL at follow-up and right ventricle dysfunction at the diagnosis were independent predictors of incomplete recanalization (OR 18.58 (95% CI 1.97-175.19) and 7.03 (95% CI 1.43-34.6), respectively, p=0.0006). CONCLUSION: Elevated D-dimer after 6 months anticoagulation and right ventricular dysfunction at the diagnosis predict incomplete recanalization of pulmonary circulation after first episode of APE. |
| | |
Authors:
|
Anna Kaczyńska; Maciej Kostrubiec; Ryszard Pacho; Jolanta Kunikowska; Piotr Pruszczyk |
Related Documents
:
|
4082124 - A comparison of impedance plethysmography and strain gauge plethysmography in the diagn... 300214 - Eisenmenger's syndrome in pregnancy: does heparin prophylaxis improve the maternal mort... 2115254 - Ovarian vein thrombosis in oncology patients: ct detection and clinical significance. 3413654 - Ultrasonic real time guidance for subclavian venipuncture. 14994294 - A comparison between the accuracy of voxel-based morphometry and hippocampal volumetry ... 9594854 - Surgical management of hemorrhage from rupture of the aortic arch. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2007-10-10 |
Journal Detail:
|
Title: Thrombosis research Volume: 122 ISSN: 0049-3848 ISO Abbreviation: Thromb. Res. Publication Date: 2008 |
Date Detail:
|
Created Date: 2008-04-28 Completed Date: 2008-08-11 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0326377 Medline TA: Thromb Res Country: United States |
Other Details:
|
Languages: eng Pagination: 21-5 Citation Subset: IM |
Affiliation:
|
Department of Internal Medicine and Cardiology, Medical University of Warsaw, Poland. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Acenocoumarol
/
therapeutic use Adult Aged Anticoagulants / therapeutic use* Area Under Curve Biological Markers / blood Female Fibrin Fibrinogen Degradation Products / metabolism* Follow-Up Studies Heparin, Low-Molecular-Weight / therapeutic use Humans Male Middle Aged Pulmonary Artery / surgery* Pulmonary Embolism / drug therapy*, radiography, surgery* Tomography, Spiral Computed |
| Chemical | |
Reg. No./Substance:
|
0/Anticoagulants; 0/Biological Markers; 0/Fibrin Fibrinogen Degradation Products; 0/Heparin, Low-Molecular-Weight; 0/fibrin fragment D; 152-72-7/Acenocoumarol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Analysis of a T-287C polymorphism in the tissue factor pathway inhibitor gene and identification of ...
Next Document: Use of functional highly purified human platelets for the identification of new proteins of the IPP ...