Abstract
Background
The prognostic value of D-dimer testing in patients with acute pulmonary embolism
(PE) has not been thoroughly studied.
Methods
We used the RIETE Registry data to assess the 90-day prognostic value of increased
IL Test D-dimer® levels at baseline in patients with PE, according to the presence or absence of cancer.
Results
As of May 2013, 3,283 patients with acute PE underwent D-dimer testing using IL Test D-dimer®. Among 2,588 patients without cancer, those with D-dimer levels in the highest quartile
had a higher rate of fatal PE (2.6% vs. 0.9%; p = 0.002), fatal bleeding (1.1% vs. 0.3%; p = 0.017) and all-cause death (9.1% vs. 4.4%; p < 0.001) at 90 days compared with those with levels in the lowest quartiles. Among 695 patients with
cancer, those with levels in the highest quartile had a similar rate of fatal PE or
fatal bleeding but higher mortality (35% vs. 24%; p < 0.01). On multivariate analysis, non-cancer patients with D-dimer levels in the highest
quartile had an increased risk for fatal PE (odds ratio [OR]: 3.3; 95% CI: 1.6-6.6),
fatal bleeding (OR: 4.3; 95% CI: 1.4-13.7) and all-cause death (OR: 2.1; 95% CI: 1.4-3.1)
compared with patients with levels in the lowest quartiles.
Conclusions
Non-cancer patients with acute PE and IL Test D-dimer® levels in the highest quartile had an independently higher risk for fatal PE, fatal
bleeding and all-cause death at 90 days than those with levels in the lowest quartiles. In patients with cancer, D-dimer
levels failed to predict fatal PE or fatal bleeding.
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Article info
Publication history
Published online: January 17, 2014
Accepted:
December 31,
2013
Received in revised form:
November 4,
2013
Received:
July 23,
2013
Identification
Copyright
© 2014 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
