TUESDAY, May 11 (HealthDay News) -- During anticoagulation therapy for atrial fibrillation, D-dimer values may be useful in prediction of thromboembolic and cardiovascular events, according to a study in the May 18 issue of the Journal of the American College of Cardiology.
Tsuneaki Sadanaga, M.D., of Ueki Hospital in Japan, and colleagues conducted a prospective, observational study of 269 warfarin-treated patients with atrial fibrillation. D-dimer levels were measured; the end points were thromboembolic events and combined cardiovascular events (thromboembolic events, cerebral hemorrhage, myocardial infarction, cardiovascular death) over an average follow-up of 756 days.
The researchers found that D-dimer levels were elevated in 23 percent of patients. Thromboembolic events occurred at a rate of 1.8 percent per year, and combined cardiovascular events occurred at a rate of 4.8 percent per year. Elevated D-dimer levels were associated with a higher incidence of thromboembolic events (hazard ratio, 15.8) and combined cardiovascular events (hazard ratio, 7.64).
"It has been suggested that modestly elevated circulating D-dimer values reflect minor increases in blood coagulation, thrombin formation, and turnover of cross-linked intravascular fibrin. These increases might be related to thromboembolic and cardiovascular events. This study was consistent with these results. Interestingly, elevated D-dimer levels also predicted bleeding complications in this study. The reasons were not known, but it can be speculated that the fibrinolytic activation of which D-dimer is a marker might itself predispose to bleeding," the authors write.
Abstract
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