D-Dimer as a Predictive Marker for Recurrence Following the First Unprovoked Attack of Venous Thromboembolism

Definition of the optimal period for anticaogulation following the first unprovoked attack of venous thromboembolism is quite challenging. This study tried to identify a D-dimer as a possible marker for the prediction of recurrence of venous thromboembolism. Patients and Methods: The study included 121 patients diagnosed with a first unprovoked episode of deep venous thrombosis of the lower limb and/or pulmonary embolism, and were prospectively investigated after the discontinuation of oral anticoagulant therapy. D-dimer levels in plasma were measured 1 month after stopping of the oral anticoagulant therapy. The study endpoint was the occurrence of recurrent attack of venous thromboembolism. Results: Twenty six patients (21.7%) had recurrent VTE during an average follow up period of 12 months, 17 patients (14.2%) had elevated D-dimer level, while 9 patients (7.5%), had normal D-dimer level. Conclusion: D-dimer measurment following the discon-tinuation of oral anticoagulant therapy following an attack of venous thromboembolism seems to have a good predictive value for the occurrence of recurrence, however multiple risk factors are involved, that have to be considered, and if optimized D-dimer would be a useful predictor marker.