D-dimer levels at diagnosis and long-term clinical outcomes in venous thromboembolism: from the COMMAND VTE Registry View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-09-30

AUTHORS

Maki Oi, Yugo Yamashita, Mamoru Toyofuku, Takeshi Morimoto, Yasuyo Motohashi, Takashi Tamura, Kazuaki Kaitani, Hidewo Amano, Toru Takase, Seiichi Hiramori, Kitae Kim, Masaharu Akao, Yohei Kobayashi, Tomohisa Tada, Po-Min Chen, Koichiro Murata, Yoshiaki Tsuyuki, Syunsuke Saga, Tomoki Sasa, Jiro Sakamoto, Minako Kinoshita, Kiyonori Togi, Hiroshi Mabuchi, Kensuke Takabayashi, Hiroki Shiomi, Takao Kato, Takeru Makiyama, Koh Ono, Takeshi Kimura

ABSTRACT

The relationship between D-dimer level at diagnosis and long-term clinical outcomes has not been fully evaluated in venous thromboembolism (VTE). The COMMAND VTE Registry is a multicenter registry enrolling consecutive acute symptomatic VTE patients in Japan. Patients with available D-dimer levels at diagnosis (N = 2852) were divided into 4 groups according to the D-dimer levels; Quartile 1 (0.0–4.9 µg/mL): N = 682, Quartile 2 (5.0–9.9 µg/mL) N = 694, Quartile 3 (10.0–19.9 µg/mL) N = 710, and Quartile 4 (≥ 20.0 µg/mL): N = 766. The cumulative incidence of all-cause death was higher in Quartile 4 throughout the entire follow-up period (19.9%, 24.9%, 28.8%, and 41.5% at 5-year, P < 0.0001), as well as both within and beyond 30-day. After adjustment, the excess risk of Quartile 4 relative to Quartile 1 for all-cause death remained significant (HR 1.60, 95% CI 1.29–2.03). Similarly, the excess risk of Quartile 4 relative to Quartile 1 for recurrent VTE was significant (HR 1.57, 95% CI 1.02–2.41), which was more prominent in the cancer subgroup. The dominant causes of death in Quartile 4 were pulmonary embolism within 30-day, and cancer beyond 30-day. In conclusions, in VTE patients, elevated D-dimer levels at diagnosis were associated with the increased risk for both short-term and long-term mortality. The higher mortality risk of patients with highest D-dimer levels was driven by the higher risk for fatal PE within 30-day, and by the higher risk for cancer death beyond 30-day. Elevated D-dimer levels were also associated with the increased risk for long-term recurrent VTE, which was more prominent in patients with active cancer. More... »

PAGES

551-561

References to SciGraph publications

Journal

TITLE

Journal of Thrombosis and Thrombolysis

ISSUE

4

VOLUME

49

Author Affiliations

  • Department of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan
  • Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
  • Department of Cardiology, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubara-dori, 640-8558, Wakayama, Japan
  • Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
  • Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, Japan
  • Department of Cardiology, Kinki University Hospital, Osaka, Japan
  • Department of Cardiology, Kokura Memorial Hospital, Kokura, Japan
  • Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
  • Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
  • Department of Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan
  • Department of Cardiology, Shizuoka General Hospital, Shizuoka, Japan
  • Department of Cardiology, Osaka Saiseikai Noe Hospital, Osaka, Japan
  • Department of Cardiology, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
  • Division of Cardiology, Shimada Municipal Hospital, Shimada, Japan
  • Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
  • Department of Cardiology, Kishiwada City Hospital, Kishiwada, Japan
  • Department of Cardiology, Tenri Hospital, Tenri, Japan
  • Department of Cardiology, Nishikobe Medical Center, Kobe, Japan
  • Division of Cardiology, Nara Hospital, Kinki University Faculty of Medicine, Ikoma, Japan
  • Department of Cardiology, Koto Memorial Hospital, Higashiomi, Japan
  • Department of Cardiology, Hirakata Kohsai Hospital, Hirakata, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11239-019-01964-0

    DOI

    http://dx.doi.org/10.1007/s11239-019-01964-0

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1121397369

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/31571121


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