The importance of D-dimer test in the follow up of patients with deep venous thrombosis

Abstract

INTRODUCTION: Although deep venous thrombosis (DVT) is a treatable disease, it has a strong tendency to recur leading to serious complications such as pulmonary embolism and post-thrombotic syndrome. D-dimer testing one month after the completion of anticoagulant therapy may give an idea about the risk of recurrence of disease. The aim of this study was to investigate the predictive value of D-dimer testing for recurrent events after withdrawal of coumadin therapy in patients with DVT. METHODS: This study included 70 patients with unprovoked DVT. The diagnosis of DVT was confirmed by venous Doppler ultrasonography. All patients underwent D-dimer testing approximately one month after coumadin withdrawal and they were followed 18 months. RESULTS: There were 36 male and 34 female patients with age range 32-76 years and mean age 54.3+-13.2 years. Twenty one (30%) patients had positive D-dimer testing. While 10 (20.4%) of the 49 patients with negative D-dimer testing had residual venous obstruction (RVO), 12 (57.4%) of the 21 patients with positive D-dimer testing had RVO. In 12 patients with positive D-dimer testing and RVO, duration of coumadin therapy was prolonged for 6 months. In the remaining 58 patients, DVT recurred in 8 (%13,8) patients, of whom one was found to be homozygous FVL polymorphism. DISCUSSION AND CONCLUSION: D-dimer testing should be useful to predict recurrent events one month after the discontinuing of coumadin therapy in patients with DVT. Resumption of anticoagulation therapy may be useful in patients with positive D-dimer testing. However, other clinical conditions affecting the D-dimer levels should be taken into consideration.

Keywords

• d-dimer
• coumadin
• anticoagulation
• venous thrombosis