This article is more than 5 years old. Information may no longer be current.
Normal D-dimer levels after anticoagulant therapy may indicate lower recurrence of VTE
Click Here to Manage Email Alerts
Women with normal D-dimer levels after anticoagulant treatment for a first unprovoked venous thromboembolism may have a low enough recurrence risk to justify stopping therapy, according to study results.
However, recurrence risk among men who meet this criteria does not appear to be low enough to justify stopping anticoagulant therapy, results showed.
Clive Kearon, MB, PhD, professor of medicine at McMaster University in Ontario, Canada, and colleagues conducted a masked, prospective management study at 13 university-affiliated clinical centers to evaluate VTE recurrence risk in patients after withdrawal of anticoagulant therapy.
Investigators analyzed data from 410 patients aged 75 years or younger who had completed 3 to 7 months of anticoagulant therapy for a first unprovoked proximal deep venous thrombosis or pulmonary embolism.
Patients with negative D-dimer results stopped anticoagulant therapy and did not restart therapy if results were still negative after 1 month.
After mean follow-up of 2.2 years, 319 (78%) patients had two negative D-dimer results and did not resume anticoagulant therapy. Forty-two of those patients experienced VTE recurrence, translating to an overall recurrence rate of 6.7% (95% CI, 4.8-9) per patient-year.
VTE recurrence rates were 9.7% (95% CI, 6.7-13.7) per patient-year among men (n=180); 5.4% (95% CI, 2.5-10.2) per patient-year among women with VTE not associated with estrogen therapy (n=81); and 0% (95% CI, 0-3) per patient-year among women with estrogen therapy-associated VTE (n=58; P=.001 for the comparison).
The analysis was limited by imprecision in female subgroups, and the results may not be generalizable to other D-dimer assays that were not analyzed in this study, according to researchers.
Disclosure: The study was funded by the Canadian Institutes of Health Research. Alere provided D-dimer assays for the study. Kearon reports financial associations with Bayer and Boehringer Ingelheim. See the full study for a list of the other researchers’ relevant financial disclosures.
Click Here to Manage Email Alerts