Influence of C‐reactive protein levels and age on the value of D‐dimer in diagnosing pulmonary embolism

Crop, Meindert J.; Siemes, Claire; Berendes, Paul; Straaten, Frans van der; Willemsen, Sten P.; Levin, Mark‐David

doi:10.1111/ejh.12218

Cited by 18 publications

(8 citation statements)

References 31 publications

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“…There is a high incidence rate of deep venous thrombosis (DVT) of lower extremity in China, and the pulmonary thromboembolism formed by detachment of thrombus is the leading cause for death of people (1). Studies have suggested that inflammatory reaction plays a key role in the occurrence and development of DVT, and that inflammatory cytokine is a bioactive peptide that not only acts as a signal transduction factor, but also performs as an effector molecule (2).…”

Section: Introductionmentioning

confidence: 99%

Expression variations and clinical significance of MMP-1, MMP-2 and inflammatory factors in serum of patients with deep venous thrombosis of lower extremity

Zhang¹,

Li²,

Wang³

et al. 2018

Exp Ther Med

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Expression levels and clinical significance of matrix metalloproteinase-1 (MMP1), MMP-2 and inflammatory factors in the serum of patients with deep venous thrombosis (DVT) of lower extremity were investigated. Fifty untreated DVT patients were selected as the DVT group, and 50 patients undergoing health examination were enrolled as the normal control group. Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of MMP-1, MMP-2, interleukin-6 (IL-6), IL-8 and tumor necrosis factor-α (TNF-α) in the serum. Western blotting was adopted to detect the expression levels of MMP-1 and MMP-2 proteins. Fluorescent reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was applied to examine the messenger ribonucleic acid (mRNA) expression levels. Moreover, the circumferences of the patients were measured. The difference between the circumference of affected extremity and unaffected extremity was calculated. Correlation analysis was conducted separately for the levels of serum MMP-1, MMP-2, IL-6, IL-8 and TNF-α of patients in the DVT group. In the DVT group, the levels of MMP-1, MMP-2, IL-6, IL-8, and TNF-α at 7 days after treatment were significantly lower than those before treatment (P<0.01). Compared with that before treatment, the circumference difference of the affected and unaffected extremities of the patients was reduced at 7 days after treatment (P<0.01). The levels of IL-6, IL-8 and TNF-α were positively correlated with the levels of MMP-1 and MMP-2, respectively in the DVT group (P<0.05 or P<0.01). MMP-1, MMP-2 and inflammatory factors play an important role in the occurrence and development of DVT, of which the levels of IL-6, IL-8 and TNF-α are positively correlated with the levels of MMP-1 and MMP-2, respectively. Therefore, monitoring the concentration of MMP-1, MMP-2 and inflammatory factors is of significant value for the diagnosis, progression and judgement of treatment effect of DVT in clinical practice.

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Section: Introductionmentioning

confidence: 99%

Expression variations and clinical significance of MMP-1, MMP-2 and inflammatory factors in serum of patients with deep venous thrombosis of lower extremity

Zhang¹,

Li²,

Wang³

et al. 2018

Exp Ther Med

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“…A recent study showed a correlation between hs-CRP and D-dimer in patients with pulmonary embolism 29 . According to our research, a stronger baseline correlation was found between hs-CRP and D-dimer than between hs-CRP and fibrinogen in the males as baseline.…”

Section: Discussionmentioning

confidence: 97%

Correlation between coagulation and inflammation state in patients with diabetes mellitus type 2 in relation to gender differences: Is there any impact of eight-week exercise training?

Trebinjac

Petronić²,

Lalić

et al. 2019

VOJNOSANIT PREGL

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Background/Aim. The hypercoagulable state and inflammation state in diabetics has been widely studied by previous researchers, but there is a lack of research about a possible impact of exercise training on this relationship. The aim of this study was to assess and compare correlation between the coagulation and inflammation status in patients with type 2 diabetes mellitus taking into account the gender differences as well as an impact of the 8-week exercise training on the correlation coefficient and parameters of the inflammation and coagulation state. Methods. A total of 60 patients in stable clinical condition and well-regulated diabetic status passed through all phases of the study. The exercise training included the exercise program as interval training with estimated intensity uphill to 75% of a maximal heart rate in particular individual, 5 times a week for 8 weeks, and walking for 30 minutes with a speed of 5 km/h, 5 times a week for 8 weeks. Further fibrinolytic, coagulation and inflammatory parameters were analyzed before and after the study: D-dimer, von Willebrand factor (vWF), fibrinogen, high sensitivity CRP (hs-CRP), leukocytes, thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT) and coagulation factors: FII, FV, FVII and FX. Results. Our research showed a statistically significant reduction in the mean vWF levels after intervention both at the males (p < 0.001) and females (p < 0.001). According to a correlation analysis between hs-CRP and fibrinogen, there was a positive correlation as baseline both at the males (p < 0.05, r = 0.492) and females (p < 0.01, r = 0.516) which became weaker in the males (p < 0.01, r = 0.449) and disappeared in the females (p < 0.05, r = 0.059) after intervention. The correlation which existed as baseline in the males between D-dimer and either hs-CRP (p < 0.01, r = 0.633) or fibrinogen (p < 0.01, r = 0.673) as well as the correlation between hs-CRP and FII (p < 0.01, r = 0.728), FV (p < 0.05, r = 0.366), FVII (p < 0.05, r = 0.373) coagulation as well as between D-dimer and FII (p < 0.01, r = 0.851), FVII (p < 0.05, r = 0.367)was absent in the females. Our research demonstrated a weakening correlations in the males after intervention between D-dimer and hs-CRP (p < 0.05, r = 0.378), between hs-CRP and FII (p < 0.01, r = 0.501), FV (p < 0.05, r = 0.298), FVII (p < 0.05, r = 0.351) as well as between D-dimer and FII (p < 0.01, r = 0.759), and FVII (p < 0.05, r = 0.296). The increase of the FX values (p < 0.05) in the females after intervention suggested the possible antiinflammatory effect of exercise training. Conclusion. According to previous research, the higher levels of vWF was associated with a risk of cardiovascular disease in people with type 2 diabetes mellitus and vWF may be a risk factor unique to these populations. We demonstrated that the 8-week exercise training can significantly reduce the value of vWF in the males and females, suggesting a potential beneficial effect on the endothelial function parameters. Our research demonstrated a stronger correlation between the coagulation and inflammation parameters as baseline in the males than in the females with type 2 diabetes mellitus. According to our results, the 8-week exercise training lead to a weakening of the strength of correlation between the coagulation and inflammation parameters in the males and complete disappearance of this correlation in the females, suggesting a unique effect of exercise training that should be explored in future research.

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“…1,2 Age, active malignancy, infection, pregnancy and use of anticoagulants are well known to have an influence on D-dimer levels. [3][4][5][6] Use of medication with an effect on thrombus formation, such as HMG-CoA reductase inhibitors, more commonly known as statins, may influence D-dimer levels as well. These antithrombotic properties are part of what has been referred to as the cholesterol-independent or "pleiotropic" effects of statins, explaining why the benefits observed with statins appear to exceed what might be expected from changes in cholesterol levels alone.…”

Section: Introductionmentioning

confidence: 99%

A revised systematic review and meta‐analysis on the effect of statins on D‐dimer levels

Schol-Gelok

Morelli

Arends

et al. 2019

Eur J Clin Investigation

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Background D‐dimers are generated during endogenous fibrinolysis of a blood clot and have a central role in diagnostic algorithms to rule out venous thromboembolism. HMG‐CoA reductase inhibitors, more commonly called statins, are known to have effects independent of LDL‐cholesterol lowering, including antithrombotic properties. An effect of statins on D‐dimer levels has been reported in a prior systematic review and meta‐analysis, but methodological shortcomings might have led to an overestimated effect. To re‐evaluate the association between statins and D‐dimer levels, we systematically reviewed all published articles on the influence of statins on D‐dimer levels and conducted a novel meta‐analysis (PROSPERO registration number CRD42017058932). Materials and methods We electronically searched EMBASE, Medline Epub, Cochrane, Web of Science and Google Scholar (100 top relevance) (date of last search: 5 October 2017). We included randomized controlled trials, cohort studies and cross‐sectional studies. Two reviewers independently screened all articles retrieved and extracted data on study and patient characteristics, study quality and D‐dimer levels. Results Study‐level meta‐analysis involving 18,052 study participants showed lower D‐dimer levels in those receiving statin treatment than controls (SMD: −0.165, 95% CI −0.234; −0.096, P = <0.001). Sensitivity analyses and additional analyses on treatment duration (<12 weeks vs ≥12 weeks) and type of statin (lipophilic or hydrophilic) did not modify this overall result. Conclusion This meta‐analysis suggests an association between use of statins and reduction of D‐dimer levels, independent of treatment duration and type of statin used. This effect is small but robust, and should be interpreted with caution.

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Influence of C‐reactive protein levels and age on the value of D‐dimer in diagnosing pulmonary embolism

Cited by 18 publications

References 31 publications

Expression variations and clinical significance of MMP-1, MMP-2 and inflammatory factors in serum of patients with deep venous thrombosis of lower extremity

Expression variations and clinical significance of MMP-1, MMP-2 and inflammatory factors in serum of patients with deep venous thrombosis of lower extremity

Correlation between coagulation and inflammation state in patients with diabetes mellitus type 2 in relation to gender differences: Is there any impact of eight-week exercise training?

A revised systematic review and meta‐analysis on the effect of statins on D‐dimer levels

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