Thrombosis Research Center (TREC), Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway; Thrombosis Research Group (TREC), Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway.
Internal Medicine Clinic, Østfold Hospital, Kalnes, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
J Thromb Haemost. 2023 Jul;21(7):1861-1868. doi: 10.1016/j.jtha.2023.03.026. Epub 2023 Mar 31.
Venous thromboembolism (VTE) is a frequent disease with a high risk of recurrence. It has been suggested that the D-dimer level at the time of VTE diagnosis can be used to identify patients at a low risk of recurrence.
We aimed to investigate the impact of D-dimer levels measured at the time of VTE diagnosis on the risk of recurrence in a large cohort of patients with a first-time VTE.
The study included 2585 patients with first symptomatic non-cancer-associated VTE from the Venous Thrombosis Registry in Østfold Hospital (TROLL) (2005-2020). All recurrent events during the follow-up were recorded, and cumulative incidences of recurrence were estimated according to D-dimer levels of ≤1900 ng/mL (≤25th percentile) and >1900 ng/mL.
During a median follow-up of 3.3 years, 395 patients experienced a recurrent VTE. The 1- and 5-year cumulative incidences of recurrence were 2.9% (95% CI: 1.8-4.6) and 11.4% (95% CI: 8.7-14.8), respectively, in those with a D-dimer concentration of ≤1900 ng/mL and 5.0% (95% CI, 4.0-6.1) and 18.3% (95% CI: 16.2-20.6), respectively, in those with a D-dimer concentration of >1900 ng/mL, respectively. In patients with unprovoked VTE, the 5-year cumulative incidence was 14.3% (95% CI: 10.3-19.7) in the ≤1900-ng/mL category, and 20.2% (95% CI: 17.3-23.5) in the >1900-ng/mL category.
D-dimer levels within the lowest quartile, measured at the time of VTE diagnosis, were associated with lower recurrence risk. Our findings imply that D-dimer levels measured at the time of diagnosis may be used to identify patients with VTE at a low risk of recurrent VTE.
静脉血栓栓塞症（VTE）是一种常见疾病，具有很高的复发风险。有研究表明，VTE 诊断时的 D-二聚体水平可用于识别复发风险较低的患者。
我们旨在调查首次 VTE 患者中，VTE 诊断时测量的 D-二聚体水平对复发风险的影响。
该研究纳入了来自 Østfold 医院静脉血栓形成登记处（TROLL）的 2585 例首次有症状的非癌症相关 VTE 患者（2005-2020 年）。记录随访期间的所有复发事件，并根据 D-二聚体水平≤1900ng/ml（≤25 百分位数）和＞1900ng/ml 估计复发的累积发生率。
在中位随访 3.3 年期间，395 例患者发生了 VTE 复发。D-二聚体浓度≤1900ng/ml 的患者 1 年和 5 年的累积复发率分别为 2.9%（95%CI：1.8-4.6）和 11.4%（95%CI：8.7-14.8），而 D-二聚体浓度＞1900ng/ml 的患者分别为 5.0%（95%CI，4.0-6.1）和 18.3%（95%CI：16.2-20.6）。在无诱因 VTE 患者中，D-二聚体浓度≤1900ng/ml 组的 5 年累积发生率为 14.3%（95%CI：10.3-19.7），而 D-二聚体浓度＞1900ng/ml 组为 20.2%（95%CI：17.3-23.5）。
VTE 诊断时测量的最低四分位数 D-二聚体水平与较低的复发风险相关。我们的研究结果表明，VTE 诊断时测量的 D-二聚体水平可用于识别复发风险较低的 VTE 患者。
