d-Dimer elevation and adverse outcomes

Halaby, Rim; Popma, Christopher J.; Cohen, Aloni; Chi, Gerald; Zacarkim, Marcelo Rodrigues; Romero, Gonzalo; Goldhaber, Samuel Z.; Hull, Russell D.; Hernandez, Adrian F.; Mentz, Robert J.; Harrington, Robert A.; Lip, Gregory Y. H.; Peacock, W. Frank; Welker, James A.; Martín‐Loeches, Ignacio; Daaboul, Yazan; Korjian, Serge; Gibson, C. Michael

doi:10.1007/s11239-014-1101-6

Cited by 103 publications

(81 citation statements)

References 50 publications

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“…Clinically, extremely elevated levels of D-dimer are a hallmark of disseminated intravascular coagulation, while D-dimer levels in the normal range are used to exclude a diagnosis of deep venous thrombosis and pulmonary embolism. 1 In healthy people, higher D-dimer predicts future risk of cardiovascular disease (CVD) events, 2, 3 particularly venous thrombosis, 4, 5 stroke, 6, 7 and all-cause mortality 8, 9 independently of conventional CVD risk factors. More modest associations have generally been observed for incident coronary heart disease (CHD).…”

Section: Introductionmentioning

confidence: 99%

D-Dimer in African Americans

Raffield

Zakai

Duan

et al. 2017

ATVB

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Objective Plasma levels of the fibrinogen degradation product D-dimer are higher among African Americans (AAs) compared to those of European ancestry and higher among women compared to men. Among AAs, little is known of the genetic architecture of D-dimer or the relationship of D-dimer to incident CVD. Approach and Results We measured baseline D-dimer in 4,163 AAs aged 21–93 years from the prospective Jackson Heart Study (JHS) cohort and assessed association with incident CVD events. In participants with whole genome sequencing data (n=2,980), we evaluated common and rare genetic variants for association with D-dimer. Each standard deviation higher baseline D-dimer was associated with a 20–30% increased hazard for incident coronary heart disease, stroke, and all-cause mortality. Genetic variation near F3 was associated with higher D-dimer (rs2022030, β= 0.284, p=3.24 × 10−11). The rs2022030 effect size was nearly three times larger among women (β= 0.373, p= 9.06 × 10−13) than men (β= 0.135, p= 0.06, p-interaction= 0.009). The sex by rs2022030 interaction was replicated in an independent sample of 10,808 multi-ethnic men and women (p-interaction=0.001). Finally, the African ancestral sickle cell variant (HBB rs334) was significantly associated with higher D-dimer in JHS (β= 0.507, p=1.41 × 10−14), and this association was successfully replicated in 1,933 AAs (p= 2.3 × 10−5). Conclusion These results highlight D-dimer as an important predictor of CVD risk in AAs and suggest that sex-specific and African ancestral genetic effects of the F3 and HBB loci contribute to the higher levels of D-dimer among women and AAs.

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Section: Introductionmentioning

confidence: 99%

D-Dimer in African Americans

Raffield

Zakai

Duan

et al. 2017

ATVB

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“…Several studies have shown an association between elevated D-dimer and increased mortality in 30 days and 3 months after PE. Similarly, it has been associated with higher mortality in cancer patients [22]. PESI was determined to be an independent prognostic factor in the 90-day follow-up period but not at 1-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

Glomerular Filtration Rate as a Prognostic Factor for Long-Term Mortality after Acute Pulmonary Embolism

2019

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Background: In-hospital mortality for patients presenting with acute pulmonary embolism (PE) has been reported to be up to 7 times higher for patients with decreased estimated glomerular filtration rate (eGFR). However, few studies have assessed its effect on long-term mortality. Objective: To determine the impact of eGFR and creatinine clearance (CrCl) on long-term all-cause mortality following acute PE in association with other routine laboratory analyses and comorbidities. Patients/Methods: The prospective study enrolled 141 consecutive patients presenting with objectively confirmed acute PE. Demographic, clinical data, comorbidities, and laboratory values were recorded. CrCl and GFR were estimated using the Cockcroft-Gault, MDRD, and chronic kidney disease (CKD)-EPI equations. Patients were followed up at 90 days and 1 year after the event. Results: In univariate analyses, age, active cancer, PE severity index (PESI), CrCl and eGFR, D-dimer value, and high-density lipoprotein level were found to be significantly associated with mortality in 90 days and 1 year. Additionally, body mass index was significant in the 1-year follow-up. CrCl by Cockcroft-Gault (90-day: area under the curve [AUC] 0.763; 1-year: AUC 0.718) demonstrated higher discriminatory power for predicting mortality than eGFR by the MDRD (AUC 0.686; AUC 0.609) and CKD-EPI (AUC 0.697; AUC 0.630) equations. In multivariate analyses, active cancer, CrCl by Cockcroft-Gault (90-day: hazard ratio [HR] 0.948, 95% CI 0.919–0.979; 1-year: HR 0.967, 95% CI 0.943–0.991), eGFR by CKD-EPI (90-day: HR 0.948, 95% CI 0.915–0.983; 1-year: HR 0.971, 95% CI 0.945–0.998) were found to be independent predictors of mortality. eGFR by MDRD, D-dimer, and PESI value were significant prognostic factors for 90-day mortality. Conclusion: Decreased renal function is a prognostic factor for increased all-cause mortality 90 days and 1 year after acute PE.

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“…Our data are in accordance with previous studies that show NTproBNP has 100% sensitivity in detecting cardiac involvement in AL amyloidosis [13] and D-dimer is a potential biomarker in cardiovascular diseases. D-dimer is a product of fibrinolysis [14][15][16][17], and plasma levels of D-dimer may indicate disease severity and predict outcome in patients with heart failure [5,14]. In addition, D-dimer has been reported as a sensitive marker for early detection of acute myocardial infarction [18].…”

Section: Discussionmentioning

confidence: 99%

“…D-dimer levels are widely used clinically to detect patients with suspected disseminated intravascular coagulation, thromboembolic events, and myocardial infarction [15]. Furthermore, D-dimer is an independent correlate of increased mortality and venous thrombosis across a variety of disease states [14,20]. D-dimer positively correlates with biomarkers of inflammation.…”

Section: D-dimer and Venous Thrombosis/inflammatorymentioning

confidence: 99%