Different cut-off values of quantitative D-dimer methods to predict the risk of venous thromboembolism recurrence: a post-hoc analysis of the PROLONG study

被引：34

作者：

Legnani, Cristina ^{[1
]}

Palareti, Gualtiero ^{[1
]}

Cosmi, Benilde ^{[1
]}

Cini, Michela ^{[1
]}

Tosetto, Alberto ^{[2
]}

Tripodi, Armando ^{[3
,4
]}

Palareti, G. ^{[5
]}

Ghirarduzzi, A. ^{[6
]}

Testa, S. ^{[7
]}

Tosetto, A. ^{[8
]}

Erba, N. ^{[9
]}

Pengo, V ^{[10
]}

Ria, L. ^{[11
]}

Pattacini, C. ^{[12
]}

Bucherini, E. ^{[13
]}

Cere, E. ^{[14
]}

Villani, C. ^{[15
]}

Prisco, D. ^{[16
]}

Trifiletti, A. ^{[17
]}

Schenone, A. ^{[18
]}

机构：

[1] Univ Hosp S Orsola Malpighi, Dept Angiol & Blood Coagulat Marino Golinelli, Via Albertoni 15, I-40138 Bologna, Italy

[2] S Bortolo Hosp, Dept Hematol, Vicenza, Italy

[3] Univ Milan, Angelo Bianchi Bonomi Hemophilia & Thrombosis Ctr, Dept Internal Med, Milan, Italy

[4] IRCCS Maggiore Hosp, Milan, Italy

[5] St Orsola Marcello Malpighi Hosp, UO Angiol & Malattie Coagulaz Marino Golinelli, Bologna, Italy

[6] Arcispedale Santa Maria Nuova, Ctr Emostasi & Trombosi, Div Med Interna 1, Reggio Emilia, Italy

[7] AO Ist Ospitalieri, Cremona, Italy

[8] Osped S Bortolo, Div Ematol, Ctr Reg Malattie Emorrag & Trombot, Vicenza, Italy

[9] Osped San Leopoldo Mand, Sez Trasfus, Merate, Italy

[10] Osped Ex Busonera, Serv Prevenz & Terapia Trombosi, Padua, Italy

[11] Osped S Cuore di Gesu, Ctr Sorveglianza Anticoagulati Malattie Coagulaz, Div Med Interna, Gallipoli, Italy

[12] Osped Reg Parma, Ctr Emostasi, Parma, Italy

[13] Presidio Osped Faenza, Lab Anal Ambulatorio Controllo Terapia Anticoagul, Faenza, Italy

[14] Osped Bentivoglio, Lab Anal, Div Cardiol, Bentivoglio, Italy

[15] Presidio Osped S Maria Incoronata dellOlmo, Lab Patol Clin, Cava Dei Tirreni, Italy

[16] AO Careggi Univ Firenze, Ctr Trombosi, Florence, Italy

[17] Univ Messina Policlin, UO Med Interna, Messina, Italy

[18] Osp Galliera, Ctr Studio Coagulopatie Rischio Trombot, Genoa, Italy

来源：

HAEMATOLOGICA | 2008年 / 93卷 / 06期

关键词：

anticoagulation; D-dimer; recurrence; risk factors; venous thromboembolism;

D O I：

10.3324/haematol.12320

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background The PROLONG study showed that patients with venous thromboembolism who had qualitatively abnormal results in a D-dimer assay (Clearview Simplify D-dimer) after discontinuation of vitamin K antagonism benefit from resumption of treatment with vitamin K antagonism. The objective of this study was to evaluate the possible advantage of using quantitative D-dimer assays. Design and Methods VIDAS D-dimer Exclusion (bioMerieux), Innovance D-DIMER (Dade Behring), HemoslL D-dimer HS (Instrumentation Laboratory) and STA Liatest D-dimer (Diagnostica Stago) assays were performed in plasma aliquots sampled 30 +/- 10 days after cessation of vitamin K antagonism in 321 patients enrolled in the PROLONG study. Results During the follow-up without vitamin K antagonism, 25 patients had recurrent venous thromboembolism. The cut-off levels of the quantitative assays giving results most comparable with those of the qualitative test were: VIDAS = 800 ng/mL; Innovance = 800 ng/mL; HemoslL HS = 300 ng/mL; STA Liatest = 700 ng/mL. When the effect of the patients' age (<= 70 vs. >70 years) was analyzed, it was found that only in younger patients was the rate of recurrence of venous thromboembolism significantly higher in patients with abnormal D-dimer levels. However, using the quantitative assays and age-specific cut-off levels it was possible to determine statistically significant hazard ratios also in elderly patients (VIDAS = 600 and 1200 ng/mL, Innovance = 500 and 900 ng/mL, HemoslL HS = 250 and 450 ng/mL, STA Liatest = 700 and 1000 ng/mL, in patients aged <= 70 and >70 years, respectively). Conclusions Quantitative D-dimer assays may provide information useful for evaluating the individual risk of recurrent venous thromboembolism. They seem particularly advantageous since they allow the selection of different cut-off levels according to the age or other characteristics of the patients.

引用

页码：900 / 907

页数：8

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