Usefulness of D-Dimer Testing in Predicting Recurrence in Elderly Patients with Unprovoked Venous Thromboembolism.

Details

Serval ID
serval:BIB_4F8AB07C25AB
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Usefulness of D-Dimer Testing in Predicting Recurrence in Elderly Patients with Unprovoked Venous Thromboembolism.
Journal
The American journal of medicine
Author(s)
Tritschler T., Limacher A., Méan M., Rodondi N., Aujesky D.
ISSN
1555-7162 (Electronic)
ISSN-L
0002-9343
Publication state
Published
Issued date
10/2017
Peer-reviewed
Oui
Volume
130
Number
10
Pages
1221-1224
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
Whether post-anticoagulation D-dimer levels are useful in predicting recurrence in elderly patients with unprovoked venous thromboembolism is unknown.
We followed up 157 patients aged ≥65 years with acute symptomatic, unprovoked venous thromboembolism in a prospective, multicenter cohort study. All patients completed 3-12 months of anticoagulation and then underwent quantitative D-dimer testing (enzyme-linked immunosorbent assay) 12 months after the index venous thromboembolism. The outcome was recurrent symptomatic venous thromboembolism after D-dimer measurement. We examined associations between log-transformed and dichotomized D-dimer values and the time to venous thromboembolism recurrence using competing risk regression, adjusting for age, sex, and overt pulmonary embolism.
There was no statistically significant association between quantitative or dichotomized D-dimer levels and venous thromboembolism recurrence. The area under the receiver operating characteristic curve for predicting recurrent venous thromboembolism was moderate (0.66; 95% confidence interval [CI], 0.51-0.82). The negative likelihood ratios were 0.34 (95% CI, 0.05-2.38) at the usual and 0.34 (95% CI, 0.09-1.29) at the age-adjusted cutoff values. Among patients with normal D-dimer results, venous thromboembolism recurrence rates were 6.8 (95% CI, 2.2-21.2) per 100 patient-years using the usual and 7.1 (95% CI, 3.2-15.8) per 100 patient-years using the age-adjusted cutoff values.
D-dimer testing alone may not be useful in identifying elderly patients with unprovoked venous thromboembolism who are at low risk of recurrent venous thromboembolism and in whom anticoagulants may be safely stopped.

Keywords
Aged, Aged, 80 and over, Anticoagulants/therapeutic use, Female, Fibrin Fibrinogen Degradation Products/analysis, Humans, Male, Predictive Value of Tests, Prospective Studies, ROC Curve, Recurrence, Venous Thromboembolism/blood, Venous Thromboembolism/diagnosis, Venous Thromboembolism/prevention & control, D-dimer, Elderly, Venous thromboembolism
Pubmed
Web of science
Create date
30/05/2017 16:45
Last modification date
20/08/2019 14:05
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