Correlation Between the Transient Increase of D-Dimer and Thrombolysis at 30d after Anticoagulation Therapy in Patients with Pulmonary Embolism

Abstract

Objective This study aimed to investigate the relationship between the transient increase in D-dimer following anticoagulant therapy and thrombolysis at 30 days in patients with pulmonary embolism (PE). Method Patients diagnosed with PE at our hospital were included in the study. CT pulmonary angiography (CTPA) was performed 7-10 days after starting anticoagulant therapy. Patients were divided into two groups: the change group and the non-change group, based on whether the thrombus had broken into smaller clots and/or dissolved compared to baseline. Plasma D-dimer levels were measured 1-10 days after anticoagulant therapy to observe any transient increase. The correlation between the transient D-dimer increase and thrombolysis at 30 days in PE patients was analyzed. Results A total of 172 patients with PE were included. The rate of thrombus change was 63.4% (75/172) at 7-10 days after anticoagulant therapy. The proportion of thrombolysis at 30 days was 68.6% (118/172). Spearman correlation analysis showed a significant correlation between the transient increase in D-dimer and thrombus changes (Rs = 0.482, P < .001), between thrombus changes and thrombolysis at 30 days (Rs = 0.413, P < .001), and between the transient increase in D-dimer and thrombolysis at 30 days (Rs = 0.540, P < .001). ROC curve analysis indicated that the transient increase in D-dimer predicted thrombus changes (AUC: 0.750, 95%CI: 0.673-0.827, P < .001), and predicted thrombolysis at 30 days (AUC: 0.786, 95%CI: 0.714-0.858, P < .001). Thrombus changes also predicted thrombolysis at 30 days (AUC: 0.712, 95%CI: 0.626-0.797, P = .001). Conclusion After anticoagulant therapy for PE, D-dimer levels may transiently increase. The rate of thrombolysis at 30 days was higher, and a transient increase in D-dimer indicated a higher likelihood of thrombolysis at 30 days.