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D-DIMER IN PATIENTS WITH VENOUS THROMBOEMBOLISM WHO CARRY HEREDITARY THROMBOPHILIA

D-DIMER IN PATIENTS WITH VENOUS THROMBOEMBOLISM WHO CARRY HEREDITARY THROMBOPHILIA. Gülfer Okumuş 1 , Rabia Ünver 1 , Koray Güven 2 , Tuba Tohumcu 2 , Esen Kıyan 1 ,Levent Tabak 1 , Halim İşsever 3 , Orhan Arseven 1 Istanbul University, Istanbul Medical Faculty,

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D-DIMER IN PATIENTS WITH VENOUS THROMBOEMBOLISM WHO CARRY HEREDITARY THROMBOPHILIA

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  1. D-DIMER IN PATIENTS WITH VENOUS THROMBOEMBOLISM WHO CARRY HEREDITARY THROMBOPHILIA Gülfer Okumuş1, Rabia Ünver1, Koray Güven2, Tuba Tohumcu2, Esen Kıyan1,Levent Tabak1, Halim İşsever3, Orhan Arseven1 Istanbul University, Istanbul Medical Faculty, Department of 1Pulmonary Disease, 2Radiology, 3Public Health

  2. D-dimerwhich is a marker of endogenous fibrinolysis increases in patients affected by thrombosis. • D-dimer when mesaured by ELISA the sensitivity is high but not spesific.

  3. The diagnosis of venous thromboembolism (VTE) is excluded with negative D-dimer test measured by ELISA (500µg/l >)

  4. The factors related to high level D-dimer • Surgery, • Trauma, • Kidney diseases, • Systemic lupus eriythematosus, • Pregnancy, • Chronic inflammmation, • Sepsis,

  5. In one study showed that, D-dimer levels measured 1 month after OATwithdrawal have high negative predictive value for recurrence in carriers of congenital thrombophilia with VTE. Gualtiero Palerati et al. Circulation 2003;108:313-318 • In another study authors found that high level D-dimer pointed out thrombophilia in women affected by sterility. Pierpaolo Di Micco. J Trans Med, 2004;2:38 • D-dimer levels were significantly higher in patients with history of VTE than asymptomatic subjects Gouin-Thibault et al. Thromb Research 2002;107:7-11

  6. Aim To investigate the relationship between D-dimer level and recurrence in patients with VTE.

  7. Material and Method • In the patients treated and followed-up in our clinic carried hereditary factors with VTE : • Venous doppler ultrasonography(US) was done from wrist of foot level to iliac vein level. • D-dimer levels were measured by VIDAS ELISA (Cutt off 500 g/L )

  8. In the patients with a high D-dimer level, the procedure was repeated after three months. • For statistical analysis x2 and Fisher Exact were used.

  9. Results • 14 male, 21 female • Age= 45.3 16.1 years (16-71 months) • Follow-up period =51  39 months • 11 patients with isolated pulmonary embolism(PE) • 6 patients with deep vein thrombosis (DVT) • 18 patients with PE + DVT

  10. 12 patients have used oral anticoagulant, • 5 patients had vena cava filters, • 14 patients had co-morbidity,

  11. 10/29 patients had high level D-dimer

  12. Carrier’s combined risk factor 3/7 patients had high level of D-dimer (p>0.05)

  13. In 13 of 35 patients the levels of D-dimer were found high, (mean = 1129 g/L)

  14. In 13 patients had chronic VTE findings in doppler-US, • In six of them, D-dimer levels were high.

  15. In the patients with high DD levels, the levels of the D-dimeranddoppler-US findingsremained unchanged after three months.

  16. There were not any correlation between level of D-dimer: • Usage of oral anticoagulant • Co-morbidity, • Sex, • Follow-up period, (p>0.05)

  17. Conclusion In our study, 1- D-dimer level was found high in the hereditary factor carriers, 2-There wasno detected recurrencein patients with high level D-dimer.

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