Original Article
d-Dimer Testing to Determine the Duration of Anticoagulation Therapy
N Engl J Med 2006; 355:1780-1789October 26, 2006
- Abstract
Background
The optimal duration of oral anticoagulation in patients with idiopathic venous thromboembolism is uncertain. Testing of d-dimer levels may play a role in the assessment of the need for prolonged anticoagulation.
Methods
We performed d-dimer testing 1 month after the discontinuation of anticoagulation in patients with a first unprovoked proximal deep-vein thrombosis or pulmonary embolism who had received a vitamin K antagonist for at least 3 months. Patients with a normal d-dimer level did not resume anticoagulation, whereas those with an abnormal d-dimer level were randomly assigned either to resume or to discontinue treatment. The study outcome was the composite of recurrent venous thromboembolism and major bleeding during an average follow-up of 1.4 years.
Results
The d-dimer assay was abnormal in 223 of 608 patients (36.7%). A total of 18 events occurred among the 120 patients who stopped anticoagulation (15.0%), as compared with 3 events among the 103 patients who resumed anticoagulation (2.9%), for an adjusted hazard ratio of 4.26 (95% confidence interval [CI], 1.23 to 14.6; P=0.02). Thromboembolism recurred in 24 of 385 patients with a normal d-dimer level (6.2%). Among patients who stopped anticoagulation, the adjusted hazard ratio for recurrent thromboembolism among those with an abnormal d-dimer level, as compared with those with a normal d-dimer level, was 2.27 (95% CI, 1.15 to 4.46; P=0.02).
Conclusions
Patients with an abnormal d-dimer level 1 month after the discontinuation of anticoagulation have a significant incidence of recurrent venous thromboembolism, which is reduced by the resumption of anticoagulation. The optimal course of anticoagulation in patients with a normal d-dimer level has not been clearly established. (ClinicalTrials.gov number, NCT00264277.)
Media in This Article
Figure 1
Enrollment and Outcomes.Figure 2
Cumulative Incidence of and Hazard Ratios (HRs) for Main Outcomes.Article Activity
- Article
Even though long-term treatment with vitamin K antagonists is highly effective in the prevention of a recurrence after a first episode of unprovoked venous thromboembolism, the optimal duration of such therapy is still uncertain.1-4 Since the risk of recurrence is greatest in the first 6 to 12 months after the initial episode and gradually diminishes thereafter,5 the benefit of an extended course of anticoagulation may be offset over time by the risk of clinically important bleeding.1-4,6,7
Earlier prospective studies involving patients with venous thromboembolism8-10 showed that the d-dimer level after anticoagulation had a highly predictive value — both positive and negative — for the occurrence of a subsequent episode of venous thromboembolism. These findings suggest that the d-dimer assay may have a role in gauging the appropriate duration of anticoagulation in such patients.
To test this hypothesis, we prospectively investigated patients after a first episode of symptomatic, unprovoked venous thromboembolism who had been treated with vitamin K antagonists for a minimum of 3 months. Patients with a normal d-dimer level did not continue anticoagulation, whereas those with an elevated d-dimer level were randomly assigned either to resume or to discontinue anticoagulation therapy.
Methods
Study Patients
The PROLONG study was a multicenter, prospective study involving patients between the ages of 18 and 85 years who had had a first episode of symptomatic, unprovoked venous thromboembolism, including proximal deep-vein thrombosis of the lower limbs, pulmonary embolism, or both. The protocol specified that deep-vein thrombosis be detected by compression ultrasonography or venography and that pulmonary embolism be diagnosed on the basis of objective algorithms with the use of clinical probability, ventilation–perfusion or helical computed tomography (CT) of the lungs, compression ultrasonography (if indicated), and d-dimer testing. Patients were eligible for the study if they had completed at least 3 months of therapy with a vitamin K antagonist (either warfarin [Coumadin, Bristol-Myers Squibb] or acenocoumarol [Sintrom, Novartis Pharma]), with a target international normalized ratio (INR) of 2.5 (range, 2.0 to 3.0).
Unprovoked venous thromboembolism was defined as an episode not associated with pregnancy or the puerperium, a recent (i.e., within 3 months) fracture or plaster casting of a leg, immobilization with confinement to bed for 3 or more consecutive days, surgery with general anesthesia lasting at least 30 minutes, cancer, the antiphospholipid antibody syndrome, or antithrombin deficiency. Patients who had serious liver disease, renal insufficiency (a plasma creatinine level >2 mg per deciliter [177 μmol per liter]), other indications or contraindications for anticoagulation, or a limited life expectancy or who lived too far from the study center were excluded. The institutional review boards of all participating clinical centers approved the study. All enrolled patients provided written informed consent.
Study Procedures
At the end of treatment with vitamin K antagonists, patients underwent a medical examination to assess their eligibility and baseline clinical condition. Patients also underwent compression ultrasonography of the proximal deep veins in both legs to assess the patency of the vessels and to measure the diameter of any residual thrombus in the common femoral, superficial femoral, and popliteal veins.11 Patients were instructed to stop oral anticoagulation and refrain from taking any other antithrombotic drugs until the next visit, which was scheduled a month later (within 20 to 40 days). Patients with venous thromboembolism that recurred between the time of the discontinuation of therapy with vitamin K antagonists and the follow-up visit were excluded from further analysis.
At the 30-day visit, venous blood was sampled for a d-dimer assay and thrombophilia test. Levels of d-dimer were assessed with the use of the Clearview Simplify d-dimer assay (Inverness Medical Professional Diagnostics), which was donated by Instrumentation Laboratory, Milan. This assay is a qualitative, fast, whole-blood method that was previously shown to perform well in the diagnostic workup for venous thromboembolism.12 Patients with a normal d-dimer level did not continue anticoagulation, whereas those with an abnormal level were randomly assigned either to resume or to discontinue anticoagulation with vitamin K antagonists (INR, 2.0 to 3.0) during the subsequent follow-up period of up to 18 months. A different randomization sequence for each study site, with a block size of 10, was generated by computer and encapsulated in a randomization program.
Testing for the presence of the antiphospholipid antibody syndrome13 and antithrombin deficiency14 was performed at the enrolling centers. Tests for factor V Leiden15 and the G20210A mutation in the prothrombin gene16 were performed at a central laboratory. Patients who were found to have the antiphospholipid antibody syndrome or antithrombin deficiency were excluded from further analysis and resumed anticoagulation. Patients with factor V Leiden or the G20210A mutation continued to participate in the study; the presence of these thrombophilias was taken into account in the multivariate analysis of the study outcome.
Study Outcomes and Follow-Up
All patients were followed for a maximum of 18 months after the assignment visit and were seen at the clinical center at intervals of 3 to 6 months. Patients were instructed to contact the clinical center immediately if symptoms developed suggestive of venous thromboembolism or in case of bleeding. The study outcome was the composite of confirmed recurrent venous thromboembolism9 and major bleeding events.
In cases of a suspected recurrence of deep-vein thrombosis, the results of compression ultrasonography were compared with those of the last available previous examination. A recurrent deep-vein thrombosis was diagnosed if a previously fully compressible segment (contralateral or ipsilateral) was no longer compressible or if an increase of at least 4 mm in the diameter of the residual thrombus during compression was detected.11 When the diameter of the thrombus changed by 1.1 to 3.9 mm, or in cases of high or moderate clinical probability and normal findings on proximal compression ultrasonography, the examination was repeated 5 to 7 days later.
In patients with suspected pulmonary embolism, the diagnosis of recurrence was based on objective algorithms17,18 with the use of clinical probability, ventilation–perfusion lung scanning or helical CT, and compression ultrasonography, d-dimer testing, or both if indicated.
Major bleeding events were defined as hemorrhages that were either retroperitoneal or intracranial or were associated with a decrease in hemoglobin of at least 2.0 g per deciliter or that required either transfusion of at least 2 units of blood or surgery or an invasive procedure to stop bleeding.6
All suspected outcome events and deaths were evaluated by a central adjudication committee whose members were unaware of the patient's name, the center where the patient had been enrolled, the results of d-dimer and thrombophilia assays, and the group assignment. Committee members also reviewed the results of all clinical investigations without knowing the patient's name, the group assignment, or the center where testing had been performed.
Statistical Analysis
Baseline differences between groups were assessed by the chi-square test with Yates' correction for categorical variables and the t-test or Mann–Whitney test for continuous variables, as appropriate. Data were analyzed according to the intention-to-treat principle. If other important clinical conditions (such as ischemic heart disease, cancer, stroke, and superficial-vein thrombosis) developed and patients changed their assigned treatment, they were regularly followed and were included in the analysis.
Kaplan–Meier survival curves were plotted to estimate the cumulative incidence of symptomatic recurrent venous thromboembolism combined with major bleeding. Hazard ratios and 95% confidence intervals (CIs) were calculated with the use of the Cox proportional-hazards model. Initially, an unadjusted hazard ratio was calculated. Then a multivariate model was constructed, including the patient's age (less than 65 years vs. 65 years or more), the duration of anticoagulation before enrollment (6 months or less vs. more than 6 months), the type of index event (deep-vein thrombosis alone vs. pulmonary embolism with or without deep-vein thrombosis), and the presence or absence of factor V Leiden or the prothrombin gene mutation. Subgroup analyses for each of these baseline variables were also performed to identify interactions between these factors and the d-dimer results. The data were analyzed with the use of Prism software, version 3.0 (GraphPad Software), and SPSS software, version 11.0 (SPSS).
Results
Patients and Treatment Groups
Figure 1Figure 1
Enrollment and Outcomes. shows a diagram of the entire study population. A total of 627 eligible patients were referred to 30 clinical centers between September 13, 2002, and January 31, 2005. Of these patients, three declined to participate in the study and five were excluded, four because of deep-vein thrombosis and one because of superficial-vein thrombosis during the interval between interruption of anticoagulation and the 1-month visit.Of the 619 patients who underwent blood sampling for a d-dimer assay and thrombophilia test, 392 (63.3%) had a normal d-dimer level. Of the remaining 227 patients with an abnormal d-dimer level, 105 were randomly assigned to resume anticoagulation and 122 were assigned to discontinue anticoagulation. After randomization, 11 patients were excluded, 9 because of the presence of lupus anticoagulant and 2 because of antithrombin deficiency. The remaining 608 patients included 385 with normal d-dimer levels and 223 with abnormal d-dimer levels, 103 of whom resumed anticoagulation and 120 who discontinued treatment. Of the group assigned to resume anticoagulation, nine patients declined to do so but were followed with their assigned group for analysis.
The baseline characteristics of the patients in the three groups are reported in Table 1Table 1
Baseline Characteristics of the 608 Study Patients.. Overall, 47.9% were women and 55.3% were 65 years of age or older; the mean age was 63 years. As expected, abnormal d-dimer levels were significantly more frequent among older patients.Follow-up
All of the study participants had a follow-up of at least 9 months; 421 (69.2%) were followed for 18 months. Three patients (all with normal d-dimer levels) moved to a different town and were lost to follow-up before the conclusion of the study. The mean duration of follow-up was 1.4 years.
During follow-up, 25 patients changed their assigned treatment because of the onset of various clinical conditions: 9 patients had superficial-vein thrombosis, 2 had ischemic heart disease (1 of whom died), 3 had cancer (2 of whom died), 2 had a suspected recurrence of deep-vein thrombosis that was not confirmed by the adjudication committee, 1 had stroke, 1 had isolated distal deep-vein thrombosis, and 7 had other conditions. The specific changes in treatment in each of the study groups are shown in Figure 1. The subsequent follow-up of these patients was included in the analysis according to the originally assigned treatment group.
Recurrent Venous Thromboembolism
Of the 120 patients with an abnormal d-dimer level who discontinued anticoagulation, 18 had recurrent venous thromboembolism (15.0%, or 10.9 events per 100 person-years) (Table 2Table 2
Main Outcomes (Intention-to-Treat Analysis).). Of the 103 patients who resumed anticoagulation, 1 had a major bleeding episode and 2 had recurrent venous thromboembolism (2.9%, or 2.0 events per 100 person-years), with one event occurring after anticoagulation was stopped. Of the 385 patients who stopped anticoagulation because they had a normal d-dimer level, 24 (6.2%, or 4.4 events per 100 person-years) presented with recurrent venous thromboembolism.Event rates were significantly higher among patients with abnormal d-dimer levels who stopped anticoagulation than among those who resumed anticoagulation (adjusted hazard ratio, 4.26; 95% CI, 1.23 to 14.6; P=0.02) or among those with normal d-dimer levels (adjusted hazard ratio, 2.27; 95% CI, 1.15 to 4.46; P=0.02) (Table 3Table 3
Hazard Ratios for Main Outcomes.). Event rates did not vary significantly between those patients with a normal d-dimer level and those with an abnormal d-dimer level who resumed anticoagulation, although a trend favoring the latter group was noted. The cumulative probability of recurrent venous thromboembolism in the study groups is shown in Figure 2Figure 2Cumulative Incidence of and Hazard Ratios (HRs) for Main Outcomes..Table 4Table 4
Hazard Ratios for Main Outcome in Subgroups. shows the hazard ratios for the main outcomes in subgroups according to baseline variables and the three possible comparisons between groups. No significant interaction was observed between the risk of recurrence in the three comparisons and categories of prespecified baseline variables when the interaction term was included in the Cox proportional-hazards model. The only exception was an interaction of sex as a variable when patients with a normal d-dimer level were compared with those with an abnormal d-dimer level who resumed anticoagulation. However, the number of patients in the study was too small to detect some clinically important interactions.Death
Three deaths occurred during follow-up, two in patients with an abnormal d-dimer level: one patient who resumed anticoagulation died from acute myocardial infarction, and one who stopped anticoagulation died from cancer about a year after randomization. The third patient, who had a normal d-dimer level, died from complications after surgery for cancer diagnosed 8 months after randomization. No deaths from recurrent venous thromboembolism or from bleeding events were recorded.
Discussion
In the PROLONG study, patients with a first episode of documented, unprovoked venous thromboembolism who had completed at least 3 months of treatment with a vitamin K antagonist stopped anticoagulation and underwent d-dimer testing 1 month later. Those with an abnormal d-dimer assay who stopped anticoagulation had a high rate of recurrent venous thromboembolism (15.0%), whereas patients with an abnormal d-dimer level who resumed anticoagulation had a combined rate of recurrent venous thromboembolism and major bleeding of 2.9% (P=0.005). The rate of recurrence in the cohort with a normal d-dimer level was also significantly lower (6.2%, P=0.005) than that in patients with an abnormal d-dimer level who stopped anticoagulation. The rate was not significantly different from that in patients with an abnormal d-dimer level who resumed anticoagulation, although the absolute difference between these two point estimates (6.2% and 2.9%) is large enough to be clinically significant. The risk–benefit relationship of prolonged anticoagulation in patients with a normal d-dimer level is therefore uncertain. In contrast, there was a clear benefit of prolonged treatment with vitamin K antagonists in patients whose d-dimer levels were abnormal a month after the discontinuation of anticoagulation. These results confirm that the d-dimer assay is correlated with the individual risk of recurrence after a first episode of venous thromboembolism and may be useful in guiding the duration of anticoagulation by helping clinicians select patients who may benefit the most from the prolongation of this demanding and risky treatment.
Patients with an abnormal d-dimer level were significantly older than those with a normal d-dimer level. Although this result is in line with findings of other reports,19 it also underlines the hypercoagulability and increased risk of venous thromboembolism in the elderly. No significant differences in d-dimer results were detected with regard to sex, the duration of anticoagulation before enrollment, the type of index event, or the presence or absence of inherited thrombophilias.
Unlike previous studies addressing the predictive role of the d-dimer assay for a recurrence of venous thromboembolism,8-10 our study adopted a qualitative rather than a quantitative method for d-dimer testing. We took this approach because we wished to have a uniform approach across the participating centers for the classification of d-dimer levels as either normal or abnormal. The quantitative d-dimer methods that were routinely used in the clinical laboratories of the participating centers differed, so results would not have been comparable.
Caution is recommended in the evaluation of our results. First, the trial was not blinded, and though committee members who were unaware of the results of the d-dimer tests and treatment assignments assessed recurrent events, bias could not be completely ruled out. However, the rates of events in the treated and untreated patients (both with abnormal and normal d-dimer levels) are in the range of those reported in the literature.
Second, d-dimer testing was performed 30 days after anticoagulation was discontinued. In a previous study,8 we reported that only 15% of patients had an abnormal d-dimer level at the time of discontinuation of anticoagulation, although the rate increased to 40.3% after 1 month and to 46.2% after 3 months. It has been reported that patients with a high d-dimer level during anticoagulation are at increased risk for recurrence during and after an interruption in anticoagulation.20,21 In this study, five patients had venous thromboembolism during the period between the discontinuation of anticoagulation and d-dimer measurement. Unfortunately, no information is available on their d-dimer levels (or those of the other patients) on the day anticoagulation was stopped. It is therefore impossible to comment on the relationship between d-dimer levels during anticoagulation and the risk of early recurrence after interruption of therapy.
Third, the d-dimer assay was performed only once, with follow-up scheduled to last for the subsequent 18 months. It is possible that during follow-up some patients with originally normal d-dimer levels could have had abnormal results on repeated testing, providing a detectable warning sign of recurrent hypercoagulability and an increased risk of thrombosis. Repeated d-dimer assays in patients with an originally normal level may be useful in detecting a late relapse related to hypercoagulability, but this hypothesis should be assessed in future studies.
Fourth, although the study was large enough to detect significant differences between groups in the frequency of the combined end point of recurrent venous thromboembolism or bleeding, it was not large enough to make a definitive assessment of the relative risk of bleeding, considered alone, with continued anticoagulation. Since the risk of bleeding increases with time and since the clinical consequences of severe bleeding (such as intracranial hemorrhage) may outweigh those of recurrent venous thromboembolism (such as a deep-vein thrombosis that is detected and treated), clinicians should keep this issue in mind when they are treating a patient who is receiving a prolonged course of a vitamin K antagonist.
Finally, we included only patients with a first unprovoked venous thromboembolism, since the optimal duration of anticoagulation is most uncertain in this category of patients. However, a management strategy for all groups of patients, regardless of the nature and number of their previous events, would be of great practical use. These issues remain to be addressed by specifically designed clinical studies.
In conclusion, we evaluated patients with a first documented, unprovoked episode of venous thromboembolism who had been treated with a vitamin K antagonist for at least 3 months. Anticoagulation was discontinued, and qualitative d-dimer testing was performed 1 month later. Patients with an abnormal d-dimer test who resumed anticoagulation had a significantly lower combined incidence of recurrent venous thromboembolism and bleeding than did those who did not resume anticoagulation. Patients with a normal d-dimer level did not resume anticoagulation. The optimal course of therapy for such patients is not clearly established.
Supported by the Italian Federation of Anticoagulation Clinics and by the Department of Angiology and Blood Coagulation of the S. Orsola-Malpighi University Hospital of Bologna, Italy. Instrumentation Laboratory in Milan provided the kits for d-dimer measurement (Clearview Simplify d-dimer assay).
Drs. Palareti, Cosmi, Legnani, Pengo, Testa, and Tripodi report having received lecture fees from Instrumentation Laboratory. No other potential conflict of interest relevant to this article was reported.
Source Information
From the S. Orsola-Malpighi University Hospital, Bologna, (G.P., B.C., C.L., C.B.); S. Bortolo Hospital, Vicenza (A. Tosetto); the University of Perugia, Perugia (A.I.); the University Hospital, Padua (V.P.); Arcispe-dale Santa Maria Nuova, Reggio Emilia (A.G.); General Hospital, Parma (C.P.); General Hospital, Cremona (S.T.); and Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Istituto di Ricovero e Cura a Carattere Scientifico, Maggiore Hospital, Milan (A. Tripodi) — all in Italy; and the Academic Medical Center, Amsterdam (A.W.A.L.).
Address reprint requests to Dr. Palareti at the Department of Angiology and Blood Coagulation, S. Orsola-Malpighi University Hospital, Via Albertoni 15, 40138 Bologna, Italy, or at palareti@tin.it.
The PROLONG Investigators are listed in the Appendix.
Appendix
The following were members of the PROLONG study group; all the participating centers are affiliated with the Italian Federation of Anticoagulation Clinics (the numbers of patients who participated in the study appear in parentheses): Policlinico S. Orsola-Malpighi, Bologna — G. Palareti, B. Cosmi, C. Legnani, C. Brusi (148); Azienda Ospedaliera “Istituti Ospitalieri,” Cremona — S. Testa, A. Alatri (79); Arcispedale Santa Maria Nuova, Reggio Emilia — A. Ghirarduzzi, A. Iorio (68); Ospedale S. Bortolo, Vicenza — A. Tosetto (36); Ospedale “Ex Busonera,” Padua — V. Pengo, C. Pegoraro, S. Iliceto (27); Azienda Policlinico Universitario di Palermo, Palermo — S. Siragusa (27); Azienda Ospedaliera di Careggi Universita' di Firenze, Florence — D. Prisco, D. Poli (26); Ospedale Ca' Granda Niguarda, Milan — F. Baudo (25); Policlinico “Le Scotte,” Siena — R. Cappelli (20); Ospedale San Leopoldo Mandic, Merate — N. Erba (18); Ente Ospedaliero di Vimercate, Vimercate — L. La Rosa (16); Ospedale Regionale, Parma — C. Pattacini, R. Quintavalla (15); Ospedale “S. Cuore di Gesù,” Gallipoli — L. Ria (14); Presidio Ospedaliero di Faenza, Faenza — E. Bucherini (12); Ospedale di Bentivoglio, Bentivoglio — E. Cerè (11); Ospedale dell'Annunziata, Cosenza — V. Rossi (9); Ospedale degli Infermi, Rimini — E. Tiraferri (9); Azienda Ospedaliera Bolognini, Seriate — C. Agazzi, N. Coffetti (9); Presidio Ospedaliero S. Maria Incoronata dell'Olmo, Cava dei Tirreni — C. Villani (8); Ospedale Valduce, Como — L. Frigerio (7); Arcispedale S. Anna, Ferrara — G. Scapoli (7); Policlinico Universitario Messina, Messina — A. Trifiletti (6); Ospedale Maria Vittoria, Turin — M. Molinatti (6); Azienda Ospedaliera “Ospedale Treviglio-Caravaggio,” Treviglio — P. Dori Faccini (5); Azienda Ospedaliera S. Antonio e Biagio, Alessandria — R. Santi (5); Ospedale Regionale di Treviso, Treviso — G. Scannapieco (4); Casa Di Cura Villa Serena, Citta' S. Angelo — G. Lessiani (3); Ospedale “G. Iazzolino,” Vibo Valentia — V. Scarmozzino (3); Presidio Ospedaliero S. Leonardo, Castellamare di Stabia — V. Imbimbo (2); and Ospedale Galliera, Genoa — A. Schenone (2). Executive Committee: G. Palareti, B. Cosmi, and C. Legnani (Bologna), A. Tosetto (Vicenza), A. Tripodi (Milan), A. Iorio (Perugia), S. Testa (Cremona). Adjudication Committee: A. Ghirarduzzi (Reggio Emilia), C. Pattacini (Parma), V. Pengo (Padua).
- References
References
1
Schulman S ,Rhedin AS ,Lindmarker P , et al. A comparison of six weeks with six months of oral anticoagulant therapy after a first episode of venous thromboembolism. N Engl J Med 1995;332:1661-1665
Full Text | Web of Science | Medline2
Kearon C ,Gent M ,Hirsh J , et al. A comparison of three months of anticoagulation with extended anticoagulation for a first episode of idiopathic venous thromboembolism. N Engl J Med 1999;340:901-907[Erratum, N Engl J Med 1999;341:298.]
Full Text | Web of Science | Medline3
Agnelli G ,Prandoni P ,Santamaria MG , et al. Three months versus one year of oral anticoagulant therapy for idiopathic deep venous thrombosis. N Engl J Med 2001;345:165-169
Full Text | Web of Science | Medline4
Pinede L ,Ninet J ,Duhaut P , et al. Comparison of 3 and 6 months of oral anticoagulant therapy after a first episode of proximal deep vein thrombosis or pulmonary embolism and comparison of 6 and 12 weeks of therapy after isolated calf deep vein thrombosis. Circulation 2001;103:2453-2460
Web of Science | Medline5
Heit JA ,Mohr DN ,Silverstein MD ,Petterson TM ,O'Fallon WM ,Melton LJ III . Predictors of recurrence after deep vein thrombosis and pulmonary embolism: a population-based cohort study. Arch Intern Med 2000;160:761-768
CrossRef | Web of Science | Medline6
Palareti G ,Leali N ,Coccheri S , et al. Bleeding complications of oral anticoagulant treatment: an inception-cohort, prospective collaborative study (ISCOAT): Italian Study on Complications of Oral Anticoagulant Therapy. Lancet 1996;348:423-428
CrossRef | Web of Science | Medline7
Kearon C ,Ginsberg JS ,Kovacs MJ , et al. Comparison of low-intensity warfarin therapy with conventional-intensity warfarin therapy for long-term prevention of recurrent venous thromboembolism. N Engl J Med 2003;349:631-639
Full Text | Web of Science | Medline8
Palareti G ,Legnani C ,Cosmi B ,Guazzaloca G ,Pancani C ,Coccheri S . Risk of venous thromboembolism recurrence: high negative predictive value of D-dimer performed after oral anticoagulation is stopped. Thromb Haemost 2002;87:7-12
Web of Science | Medline9
Palareti G ,Legnani C ,Cosmi B , et al. Predictive value of D-dimer test for recurrent venous thromboembolism after anticoagulation withdrawal in subjects with a previous idiopathic event and in carriers of congenital thrombophilia. Circulation 2003;108:313-318
CrossRef | Web of Science | Medline10
Eichinger S ,Minar E ,Bialonczyk C , et al. D-dimer levels and risk of recurrent venous thromboembolism. JAMA 2003;290:1071-1074
CrossRef | Web of Science | Medline11
Prandoni P ,Cogo A ,Bernardi E , et al. A simple ultrasound approach for detection of recurrent proximal-vein thrombosis. Circulation 1993;88:1730-1735
Web of Science | Medline12
Cini M ,Legnani C ,Cavallaroni K ,Bettini F ,Palareti G . A new rapid bedside assay for D-dimer measurement (Simplify D-dimer) in the diagnostic work-up for deep vein thrombosis. J Thromb Haemost 2003;1:2681-2683
CrossRef | Web of Science | Medline13
Wisloff F ,Jacobsen EM ,Liestol S . Laboratory diagnosis of the antiphospholipid syndrome. Thromb Res 2002;108:263-271
CrossRef | Web of Science | Medline14
Kottke-Marchant K ,Duncan A . Antithrombin deficiency: issues in laboratory diagnosis. Arch Pathol Lab Med 2002;126:1326-1336
Web of Science | Medline15
Bertina RM ,Koeleman BPC ,Koster T , et al. Mutation in blood coagulation factor V associated with resistance to activated protein C. Nature 1994;369:64-67
CrossRef | Web of Science | Medline16
Poort SR ,Rosendaal FR ,Reitsma PH ,Bertina RM . A common genetic variation in the 3′-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis. Blood 1996;88:3698-3703
Web of Science | Medline17
Fedullo PF ,Tapson VF . The evaluation of suspected pulmonary embolism. N Engl J Med 2003;349:1247-1256
Full Text | Web of Science | Medline18
Kearon C . Diagnosis of pulmonary embolism. CMAJ 2003;168:183-194
Web of Science | Medline19
Hager K ,Platt D . Fibrin degeneration product concentrations (D-dimers) in the course of ageing. Gerontology 1995;41:159-165
CrossRef | Web of Science | Medline20
Fattorini A ,Crippa L ,Vigano' D'Angelo S ,Pattarini E ,D'Angelo A . Risk of deep vein thrombosis recurrence: high negative predictive value of D-dimer performed during oral anticoagulation. Thromb Haemost 2002;88:162-163
Web of Science | Medline21
Kuruvilla J ,Wells PS ,Morrow B ,MacKinnon K ,Keeney M ,Kovacs MJ . Prospective assessment of the natural history of positive D-dimer results in persons with acute venous thromboembolism (DVT or PE). Thromb Haemost 2003;89:284-287
Web of Science | Medline
- Citing Articles (120)
Citing Articles
1
J. Thachil. (2012) Thromboneurosis. QJM
CrossRef2
Frances Caprio, Richard A. Bernstein. (2011) Duration of Anticoagulation After Cerebral Venous Sinus Thrombosis. Neurocritical Care
CrossRef3
E. Noel Savina, F. Couturaud. (2011) Durée optimale du traitement anticoagulant au décours d’une maladie veineuse thrombo-embolique. Journal des Maladies Vasculaires 36, S28-S32
CrossRef4
Benilde Cosmi, Mathilde Nijkeuter, Massimo Valentino, Menno V. Huisman, Libero Barozzi, Gualtiero Palareti. (2011) Residual emboli on lung perfusion scan or multidetector computed tomography after a first episode of acute pulmonary embolism. Internal and Emergency Medicine 6:6, 521-528
CrossRef5
F. Couturaud. (2011) Durée optimale du traitement anticoagulant au décours d’une embolie pulmonaire. Revue des Maladies Respiratoires 28:10, 1265-1277
CrossRef6
Yong Wang, Zhi-Hong Liu, Hong-Liang Zhang, Qin Luo, Zhi-Hui Zhao, Qing Zhao. (2011) Predictive value of D-dimer test for recurrent venous thromboembolism at hospital discharge in patients with acute pulmonary embolism. Journal of Thrombosis and Thrombolysis 32:4, 410-416
CrossRef7
Sergio Siragusa, Alessandra Malato, Giorgia Saccullo, Alfonso Iorio, Mauro Di Ianni, Clementina Caracciolo, Lucio Lo Coco, Simona Raso, Marco Santoro, Francesco Paolo Guarneri, Antonino Tuttolomondo, Antonio Pinto, Iliana Pepe, Alessandra Casuccio, Vincenzo Abbadessa, Giuseppe Licata, Giovan Battista Rini, Guglielmo Mariani, Gaetana Di Fede. (2011) Residual vein thrombosis for assessing duration of anticoagulation after unprovoked deep vein thrombosis of the lower limbs: The extended DACUS study. American Journal of Hematology 86:11, 914-917
CrossRef8
Zhe Wang, Junke Fu, Dongmei Diao, Chengxue Dang. (2011) Plasma D-dimer level in the perioperative period in non-small-cell lung cancer. Thoracic Cancer 2:4, 207-212
CrossRef9
Ramón Lecumberri, Carlota Pegenaute, José A. Páramo. (2011) Aplicabilidad clínica de la determinación de dímero-D en pacientes con cáncer. Medicina Clínica 137:10, 453-458
CrossRef10
Elna M. Masuda, Robert L. Kistner, Chayanin Musikasinthorn, Fernando Liquido, Olga Geling, Qimei He. (2011) The controversy of managing calf vein thrombosis: A systematic review. Journal of Vascular Surgery
CrossRef11
Daniela Poli, Massimo Miniati. (2011) The incidence of recurrent venous thromboembolism and chronic thromboembolic pulmonary hypertension following a first episode of pulmonary embolism. Current Opinion in Pulmonary Medicine 17:5, 392-397
CrossRef12
Thomas Gremmel, Cihan Ay, Daniela Seidinger, Ingrid Pabinger, Simon Panzer, Renate Koppensteiner. (2011) Soluble p-selectin, D-dimer, and high-sensitivity C-reactive protein after acute deep vein thrombosis of the lower limb. Journal of Vascular Surgery
CrossRef13
Tracy Minichiello, Lauren Doctoroff, Elizabeth A. Farrell. 2011. Treatment of Acute Venous Thromboembolism in Hospitalized Patients. , 137-160.
CrossRef14
TREVOR BAGLIN. (2011) Using the laboratory to predict recurrent venous thrombosis. International Journal of Laboratory Hematology 33:4, 333-342
CrossRef15
A. Tripodi, P. G. de Groot, V. Pengo. (2011) Antiphospholipid syndrome: laboratory detection, mechanisms of action and treatment. Journal of Internal Medicine 270:2, 110-122
CrossRef16
Elizabeth Chalmers, Vijeya Ganesen, Ri Liesner, Sanjay Maroo, Timothy Nokes, D. Saunders, Michael Williams. (2011) Guideline on the investigation, management and prevention of venous thrombosis in children*. British Journal of Haematology 154:2, 196-207
CrossRef17
Deborah A. Lewis, Gregg J. Stashenko, Olga M. Akay, Lulit I. Price, Kouros Owzar, Geoffrey S. Ginsburg, Jen-Tsan Chi, Thomas L. Ortel. (2011) Whole blood gene expression analyses in patients with single versus recurrent venous thromboembolism. Thrombosis Research
CrossRef18
Francisco Buitrago Ramírez, José Antonio Morales Gabardino, Javier Alejandre Carmona. (2011) Tratamiento y prevención secundaria del tromboembolismo. FMC - Formación Médica Continuada en Atención Primaria 18:6, 366-378
CrossRef19
Paul R.J. Ames, Maurizio Margaglione, Antonio Ciampa, Donatella Colaizzo, Felicetto Ferrara, Luigi Iannaccone, VincenzoBrancaccio. (2011) Increased warfarin consumption and residual fibrin turnover in thrombotic patients with primary antiphospholipid syndrome. Thrombosis Research 127:6, 595-599
CrossRef20
Cristina Legnani, Michela Cini, Benilde Cosmi, Paolo Carraro, Armando Tripodi, Nicoletta Erba, Gualtiero Palareti. (2011) Age and gender specific cut-off values to improve the performance of d-dimer assays to predict the risk of venous thromboembolism recurrence. Internal and Emergency Medicine
CrossRef21
Clive Kearon. (2011) Extended anticoagulation for unprovoked venous thromboembolism: a majority of patients should be treated. Journal of Thrombosis and Thrombolysis 31:3, 295-300
CrossRef22
J. Rosencher, T. Mirault, I. Martinez, T. Zhu, E. Messas, J. Emmerich. (2011) Facteurs de risque de récidive de la maladie thromboembolique veineuse. Revue des Maladies Respiratoires 28:4, 453-462
CrossRef23
B. Planquette, G. Meyer. (2011) Embolie pulmonaire aiguë : prise en charge actuelle et perspectives. Revue des Maladies Respiratoires Actualités 3, S56-S60
CrossRef24
Norikazu Yamada, Mashio Nakamura, Masaaki Ito. (2011) Current Status and Trends in the Treatment of Acute Pulmonary Thromboembolism. Circulation Journal 75:12, 2731-2738
CrossRef25
Yang-Ki Kim. (2011) Clinical Year in Review of Venous Thromboembolism. Tuberculosis and Respiratory Diseases 71:4, 245
CrossRef26
Yoshihisa Kobayashi, Takayuki Fukui, Shimon Ito, Shunzo Hatooka, Tetsuya Mitsudomi. (2011) Three cases of pulmonary embolism after surgery for lung cancer. The Journal of the Japanese Association for Chest Surgery 25:4, 373-378
CrossRef27
K. Sonnevi, S. N. Tchaikovski, M. Holmström, J. Rosing, K. Bremme, G. Lärfars. (2011) Thrombin generation and activated protein C resistance in the absence of factor V Leiden correlates with the risk of recurrent venous thromboembolism in women aged 18–65 years. Thrombosis and Haemostasis 106:5, 901-907
CrossRef28
Roman M. Sniecinski, Marcie J. Hursting, Michael J. Paidas, Jerrold H. Levy. (2011) Etiology and Assessment of Hypercoagulability with Lessons from Heparin-Induced Thrombocytopenia. Anesthesia & Analgesia 112:1, 46-58
CrossRef29
C. Ay, D. Dunkler, C. Marosi, A.-L. Chiriac, R. Vormittag, R. Simanek, P. Quehenberger, C. Zielinski, I. Pabinger. (2010) Prediction of venous thromboembolism in cancer patients. Blood 116:24, 5377-5382
CrossRef30
K. A. Bauer. (2010) Duration of Anticoagulation: Applying the Guidelines and Beyond. Hematology 2010:1, 210-215
CrossRef31
Paul Alexander Kyrle, Frits R Rosendaal, Sabine Eichinger. (2010) Risk assessment for recurrent venous thrombosis. The Lancet 376:9757, 2032-2039
CrossRef32
Clive Kearon. (2010) Long-term Anticoagulation for Venous Thromboembolism: Duration of Treatment and Management of Warfarin Therapy. Clinics in Chest Medicine 31:4, 719-730
CrossRef33
Josien van Es, Renée A. Douma, Victor E. A. Gerdes, Pieter W. Kamphuisen, Harry R. Büller. (2010) Acute pulmonary embolism. Part 2: treatment. Nature Reviews Cardiology 7:11, 613-622
CrossRef34
Gregory L. Moneta. (2010) Decreasing venous ulcers by 50% in 10 years: Five critical issues in the diagnosis and investigation of venous disease. Journal of Vascular Surgery 52:5, 44S-46S
CrossRef35
Peter Henke. (2010) Prevention and treatment of the postthrombotic syndrome. Journal of Vascular Surgery 52:5, 21S-28S
CrossRef36
T. BAGLIN, J. DOUKETIS, A. TOSETTO, M. MARCUCCI, M. CUSHMAN, P. KYRLE, G. PALARETI, D. POLI, R. C. TAIT, A. IORIO. (2010) Does the clinical presentation and extent of venous thrombosis predict likelihood and type of recurrence? A patient-level meta-analysis. Journal of Thrombosis and Haemostasis 8:11, 2436-2442
CrossRef37
Daniela Poli, Elisa Grifoni, Emilia Antonucci, Chiara Arcangeli, Domenico Prisco, Rosanna Abbate, Massimo Miniati. (2010) Incidence of recurrent venous thromboembolism and of chronic thromboembolic pulmonary hypertension in patients after a first episode of pulmonary embolism. Journal of Thrombosis and Thrombolysis 30:3, 294-299
CrossRef38
J. LATELLA, S. DESMARAIS, M.-J. MIRON, A. ROUSSIN, F. JOYAL, J. KASSIS, S. SOLYMOSS, L. DESJARDINS, J. S. GINSBERG, S. R. KAHN. (2010) Relation between D-dimer level, venous valvular reflux and the development of post-thrombotic syndrome after deep vein thrombosis. Journal of Thrombosis and Haemostasis 8:10, 2169-2175
CrossRef39
B. COSMI, C. LEGNANI, A. TOSETTO, V. PENGO, A. GHIRARDUZZI, S. TESTA, D. PRISCO, D. POLI, A. TRIPODI, G. PALARETI, . (2010) Sex, age and normal post-anticoagulation D-dimer as risk factors for recurrence after idiopathic venous thromboembolism in the Prolong study extension. Journal of Thrombosis and Haemostasis 8:9, 1933-1942
CrossRef40
H. Bounameaux. (2010) Contemporary management of pulmonary embolism: the answers to ten questions. Journal of Internal Medicine 268:3, 218-231
CrossRef41
Cameron C Trenor. (2010) Thrombosis and thrombophilia: principles for pediatric patients. Blood Coagulation & Fibrinolysis 21:Suppl 1, S11-S15
CrossRef42
Andrea T. East, Thomas W. Wakefield. (2010) What is the Optimal Duration of Treatment for DVT? An Update on Evidence-Based Medicine of Treatment for DVT. Seminars in Vascular Surgery 23:3, 182-191
CrossRef43
Armando Tripodi, Cristina Legnani, Laura Lemma, Benilde Cosmi, Gualtiero Palareti, Veena Chantarangkul, Pier Mannuccio Mannucci. (2010) Abnormal Protac-induced coagulation inhibition chromogenic assay results are associated with an increased risk of recurrent venous thromboembolism. Journal of Thrombosis and Thrombolysis 30:2, 215-219
CrossRef44
Jeanette H. Payne. (2010) Aspects of anticoagulation in children. British Journal of Haematology 150:3, 259-277
CrossRef45
Brian M. Kelly, Brian M. Yoder, Chi-Tsai Tang, Thomas W. Wakefield. (2010) Venous Thromboembolic Events in the Rehabilitation Setting. PM&R 2:7, 647-663
CrossRef46
M. Rodger, M. Carrier, E. Gandara, G. Le Gal. (2010) Unprovoked Venous Thromboembolism: Short term or Indefinite Anticoagulation? Balancing Long-Term Risk and Benefit. Blood Reviews 24:4-5, 171-178
CrossRef47
Adam Torbicki. (2010) Enfermedad tromboembólica pulmonar. Manejo clínico de la enfermedad aguda y crónica. Revista Española de Cardiología 63:7, 832-849
CrossRef48
N. Labropoulos, G. Spentzouris, A. P. Gasparis, M. Meissner. (2010) Impact and clinical significance of recurrent venous thromboembolism. British Journal of Surgery 97:7, 989-999
CrossRef49
Paul D. Stein, Fadi Matta. (2010) Acute Pulmonary Embolism. Current Problems in Cardiology 35:7, 314-376
CrossRef50
D. KEELING. (2010) Thrombophilia screening or screaming. Journal of Thrombosis and Haemostasis 8:6, 1191-1192
CrossRef51
Benilde Cosmi, Gualtiero Palareti. (2010) Update on the predictive value of D-dimer in patients with idiopathic venous thromboembolism. Thrombosis Research 125, S62-S65
CrossRef52
Timothy J. Bernard, Laura Z. Fenton, Susan D. Apkon, Richard Boada, Greta N. Wilkening, C. Corbett Wilkinson, Jennifer B. Soep, Shelley D. Miyamoto, Mark Tripputi, Jennifer Armstrong-Wells, Timothy A. Benke, Marilyn J. Manco-Johnson, Neil A. Goldenberg. (2010) Biomarkers of Hypercoagulability and Inflammation in Childhood-Onset Arterial Ischemic Stroke. The Journal of Pediatrics 156:4, 651-656
CrossRef53
B. Cosmi, C. Legnani, A. Iorio, V. Pengo, A. Ghirarduzzi, S. Testa, D. Poli, A. Tripodi, G. Palareti. (2010) Residual Venous Obstruction, alone and in Combination with D-Dimer, as a Risk Factor for Recurrence after Anticoagulation Withdrawal following a First Idiopathic Deep Vein Thrombosis in the Prolong Study. European Journal of Vascular and Endovascular Surgery 39:3, 356-365
CrossRef54
T. BAGLIN. (2010) Unraveling the thrombophilia paradox: from hypercoagulability to the prothrombotic state. Journal of Thrombosis and Haemostasis 8:2, 228-233
CrossRef55
Ida Martinelli, Paolo Bucciarelli, Pier Mannuccio Mannucci. (2010) Thrombotic risk factors: Basic pathophysiology. Critical Care Medicine 38, S3-S9
CrossRef56
B. Cosmi, C. Legnani, A. Tosetto, V. Pengo, A. Ghirarduzzi, S. Testa, D. Prisco, D. Poli, A. Tripodi, F. Marongiu, G. Palareti, . (2010) Usefulness of repeated D-dimer testing after stopping anticoagulation for a first episode of unprovoked venous thromboembolism: the PROLONG II prospective study. Blood 115:3, 481-488
CrossRef57
Aaron B. Holley, Christopher S. King, Jeffrey L. Jackson, Lisa K. Moores. (2010) Different Finite Durations of Anticoagulation and Outcomes following Idiopathic Venous Thromboembolism: A Meta-Analysis. Thrombosis 2010, 1-9
CrossRef58
Walter Ageno. (2010) Recent advances in the management of venous thromboembolism. The Korean Journal of Hematology 45:1, 8
CrossRef59
Jecko Thachil, David A. Fitzmaurice, Cheng Hock Toh. (2010) Appropriate Use of D-dimer in Hospital Patients. The American Journal of Medicine 123:1, 17-19
CrossRef60
Toshiko Uchida, Stephen D. Persell, David W. Baker. (2009) Update in General Internal Medicine. Journal of General Internal Medicine 24:12, 1327-1332
CrossRef61
Wolfgang Sturm. (2009) Tiefe Venenthrombose – TVT. Diagnose und Therapie. focus neurogeriatrie 3:3, 26-29
CrossRef62
B. Giannakopoulos, S. A. Krilis. (2009) How I treat the antiphospholipid syndrome. Blood 114:10, 2020-2030
CrossRef63
E. Bruinstroop, M.A. van de Ree, M.V. Huisman. (2009) The use of D-dimer in specific clinical conditions: A narrative review. European Journal of Internal Medicine 20:5, 441-446
CrossRef64
Richard H White, Susan Murin. (2009) Long-term incidence of death due to thromboembolic disease among patients with unprovoked pulmonary embolism. Current Opinion in Pulmonary Medicine 15:5, 418-424
CrossRef65
C. KEARON. (2009) Balancing risks and benefits of extended anticoagulant therapy for idiopathic venous thrombosis. Journal of Thrombosis and Haemostasis 7, 296-300
CrossRef66
S. EICHINGER, P. A. KYRLE. (2009) Duration of anticoagulation after initial idiopathic venous thrombosis - the swinging pendulum: Risk assessment to predict recurrence. Journal of Thrombosis and Haemostasis 7, 291-295
CrossRef67
Wolfgang Sturm. (2009) Tiefe Venenthrombose – TVT. Wiener klinische Wochenschrift Education 4:2, 57-66
CrossRef68
Guido Arpaia, Monica Carpenedo, Magda Verga, Ornella Mastrogiacomo, Daniele Fagnani, Mario Lanfredini, Massimo Milani, Claudio Cimminiello. (2009) D-dimer before chemotherapy might predict venous thromboembolism. Blood Coagulation & Fibrinolysis 20:3, 170-175
CrossRef69
E. BRUINSTROOP, F. A. KLOK, M. A. VAN DE REE, F. L. OOSTERWIJK, M. V. HUISMAN. (2009) Elevated d-dimer levels predict recurrence in patients with idiopathic venous thromboembolism: a meta-analysis. Journal of Thrombosis and Haemostasis 7:4, 611-618
CrossRef70
S. S. Adam, N. S. Key, C. S. Greenberg. (2009) D-dimer antigen: current concepts and future prospects. Blood 113:13, 2878-2887
CrossRef71
Sergio Siragusa, Domenica Caramazza, Alessandra Malato. (2009) How should we determine length of anticoagulation after proximal deep vein thrombosis of the lower limbs?. British Journal of Haematology 144:6, 832-837
CrossRef72
Jeffrey I. Weitz. (2009) Unanswered questions in venous thromboembolism. Thrombosis Research 123, S2-S10
CrossRef73
Thomas W. Wakefield, Daniel D. Myers, Peter K. Henke. (2009) Role of selectins and fibrinolysis in VTE. Thrombosis Research 123, S35-S40
CrossRef74
Jeffrey L. Spiess. (2009) Can I Stop the Warfarin? A Review of the Risks and Benefits of Discontinuing Anticoagulation. Journal of Palliative Medicine 12:1, 83-87
CrossRef75
David Garcia. (2008) Duration of anticoagulant therapy for patients with venous thromboembolism. Thrombosis Research 123, S62-S64
CrossRef76
Thomas W. Wakefield, Joseph Caprini, Anthony J. Comerota. (2008) Thromboembolic Diseases. Current Problems in Surgery 45:12, 844-899
CrossRef77
(2008) Guías de práctica clínica sobre diagnóstico y manejo del tromboembolismo pulmonar agudo. Revista Española de Cardiología 61:12, 1330.e1-1330.e52
CrossRef78
Dolores Nauffal, Liliana Chacón, Rosalía Domènech. (2008) Utilidad de las pruebas básicas en el paciente con embolia pulmonar. Medicina Clínica 131, 48-53
CrossRef79
Fernando Uresandi, Gemma Iruin, Beatriz Gómez, Amaia Uresandi. (2008) Seguimiento de la tromboembolia pulmonar. Medicina Clínica 131, 54-59
CrossRef80
José A. González-Fajardo, Miguel Martin-Pedrosa, Javier Castrodeza, Sonia Tamames, Carlos Vaquero-Puerta. (2008) Effect of the anticoagulant therapy in the incidence of post-thrombotic syndrome and recurrent thromboembolism: Comparative study of enoxaparin versus coumarin. Journal of Vascular Surgery 48:4, 953-959.e2
CrossRef81
M. BESSER, C. BAGLIN, R. LUDDINGTON, A. VAN HYLCKAMA VLIEG, T. BAGLIN. (2008) High rate of unprovoked recurrent venous thrombosis is associated with high thrombin-generating potential in a prospective cohort study. Journal of Thrombosis and Haemostasis 6:10, 1720-1725
CrossRef82
E. D. Tetzlaff, A. M. Correa, R. Komaki, S. G. Swisher, D. Maru, W. A. Ross, J. A. Ajani. (2008) Significance of thromboembolic phenomena occurring before and during chemoradiotherapy for localized carcinoma of the esophagus and gastroesophageal junction. Diseases of the Esophagus 21:7, 575-581
CrossRef83
Timothy K. Liem, Thomas G. DeLoughery. (2008) First Episode and Recurrent Venous Thromboembolism: Who is Identifiably at Risk?. Seminars in Vascular Surgery 21:3, 132-138
CrossRef84
D. LECHNER, C. WIENER, A. WELTERMANN, L. EISCHER, S. EICHINGER, P. A. KYRLE. (2008) Comparison between idiopathic deep vein thrombosis of the upper and lower extremity regarding risk factors and recurrence. Journal of Thrombosis and Haemostasis 6:8, 1269-1274
CrossRef85
A. TRIPODI, C. LEGNANI, V. CHANTARANGKUL, B. COSMI, G. PALARETI, P. M. MANNUCCI. (2008) High thrombin generation measured in the presence of thrombomodulin is associated with an increased risk of recurrent venous thromboembolism. Journal of Thrombosis and Haemostasis 6:8, 1327-1333
CrossRef86
S. Siragusa, A. Malato, R. Anastasio, V. Cigna, G. Milio, C. Amato, M. Bellisi, M. T. Attanzio, O. Cormaci, M. Pellegrino, A. Dolce, A. Casuccio, G. Bajardi, G. Mariani. (2008) Residual vein thrombosis to establish duration of anticoagulation after a first episode of deep vein thrombosis: the Duration of Anticoagulation based on Compression UltraSonography (DACUS) study. Blood 112:3, 511-515
CrossRef87
H. G. WATSON. (2008) Upper extremity deep vein thrombosis not the same disease at a different site. Journal of Thrombosis and Haemostasis 6:8, 1267-1268
CrossRef88
E. Lindhoff-Last. (2008) Global test versus profile: Will endogenous thrombin potential replace established thrombophilia screening? Contra / Global coagulation assays versus differentiated testing: Will endogenous thrombin potential replace established thrombophilia screening? Contra. 1. LaboratoriumsMedizin 32:4, ---
CrossRef89
Sabine Eichinger. (2008) Globaltest versus Profil: Wird das endogene Thrombinpotential das etablierte Thrombophiliescreening ablösen? Pro. / Global coagulation assays versus differentiated testing: will endogenous thrombin potential replace established thrombophilia screening? Pro.. LaboratoriumsMedizin 32:4, 193-196
CrossRef90
Sabine Eichinger. (2008) Global coagulation assays versus differentiated testing: will endogenous thrombin potential replace established thrombophilia screening? Pro. 1. LaboratoriumsMedizin 32:4, ---
CrossRef91
E. Lindhoff-Last. (2008) Globaltest versus Profil: Wird das endogene Thrombinpotential das etablierte Thrombophiliescreening ablösen? Contra / Global coagulation assays versus differentiated testing: will endogenous thrombin potential replace established thrombophilia screening? Contra.. LaboratoriumsMedizin 32:4, 197-199
CrossRef92
M. Righini, A. Perrier. (2008) Dosage des D-dimères et risque de récidive thromboembolique veineuse. La Revue de Médecine Interne 29:6, 476-481
CrossRef93
James E. Dalen. (2008) Should Patients with Venous Thromboembolism Be Screened for Thrombophilia?. The American Journal of Medicine 121:6, 458-463
CrossRef94
D. KEELING. (2008) Predicting the future: it’s not a SNP. Journal of Thrombosis and Haemostasis 6:5, 749-750
CrossRef95
A. VAN HYLCKAMA VLIEG, C. A. BAGLIN, L. A. BARE, F. R. ROSENDAAL, T. P. BAGLIN. (2008) Proof of principle of potential clinical utility of multiple SNP analysis for prediction of recurrent venous thrombosis. Journal of Thrombosis and Haemostasis 6:5, 751-754
CrossRef96
G. D. O. LOWE. (2008) Coagulation, genotypes and recurrent cardiovascular events: what further studies are required?. Journal of Thrombosis and Haemostasis 6:5, 717-719
CrossRef97
T. BAGLIN, C. R. PALMER, R. LUDDINGTON, C. BAGLIN. (2008) Unprovoked recurrent venous thrombosis: prediction by D-dimer and clinical risk factors. Journal of Thrombosis and Haemostasis 6:4, 577-582
CrossRef98
Paul A Kyrle, Sabine Eichinger. (2008) New diagnostic strategies for pulmonary embolism. The Lancet 371:9621, 1312-1315
CrossRef99
D. POLI, E. ANTONUCCI, G. CIUTI, R. ABBATE, D. PRISCO. (2008) Combination of D-dimer, F1+2 and residual vein obstruction as predictors of VTE recurrence in patients with first VTE episode after OAT withdrawal. Journal of Thrombosis and Haemostasis 6:4, 708-710
CrossRef100
, A. Torbicki, A. Perrier, S. Konstantinides, G. Agnelli, N. Galie, P. Pruszczyk, F. Bengel, A. J.B. Brady, D. Ferreira, U. Janssens, W. Klepetko, E. Mayer, M. Remy-Jardin, J.-P. Bassand, , A. Vahanian, J. Camm, R. De Caterina, V. Dean, K. Dickstein, G. Filippatos, C. Funck-Brentano, I. Hellemans, S. D. Kristensen, K. McGregor, U. Sechtem, S. Silber, M. Tendera, P. Widimsky, J. L. Zamorano, , J.-L. Zamorano, F. Andreotti, M. Ascherman, G. Athanassopoulos, J. De Sutter, D. Fitzmaurice, T. Forster, M. Heras, G. Jondeau, K. Kjeldsen, J. Knuuti, I. Lang, M. Lenzen, J. Lopez-Sendon, P. Nihoyannopoulos, L. Perez Isla, U. Schwehr, L. Torraca, J.-L. Vachiery. (2008) Guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). European Heart Journal 29:18, 2276-2315
CrossRef101
Tapson, Victor F., . (2008) Acute Pulmonary Embolism. New England Journal of Medicine 358:10, 1037-1052
Full Text102
Tracy Minichiello, Patrick F. Fogarty. (2008) Diagnosis and Management of Venous Thromboembolism. Medical Clinics of North America 92:2, 443-465
CrossRef103
Giancarlo Agnelli, Cecilia Becattini. (2008) Treatment of DVT: how long is enough and how do you predict recurrence. Journal of Thrombosis and Thrombolysis 25:1, 37-44
CrossRef104
H. Bounameaux, A. Perrier. (2008) Duration of Anticoagulation Therapy for Venous Thromboembolism. Hematology 2008:1, 252-258
CrossRef105
Benilde Cosmi, Cristina Legnani, Michela Cini, Elisabetta Favaretto, Gualtiero Palareti. (2008) D-dimer and factor VIII are independent risk factors for recurrence after anticoagulation withdrawal for a first idiopathic deep vein thrombosis. Thrombosis Research 122:5, 610-617
CrossRef106
N. A. Goldenberg. (2008) Thrombophilia States and Markers of Coagulation Activation in the Prediction of Pediatric Venous Thromboembolic Outcomes: A Comparative Analysis with Respect to Adult Evidence. Hematology 2008:1, 236-244
CrossRef107
Anna Kaczyńska, Maciej Kostrubiec, Ryszard Pacho, Jolanta Kunikowska, Piotr Pruszczyk. (2008) Elevated D-dimer concentration identifies patients with incomplete recanalization of pulmonary artery thromboemboli despite 6 months anticoagulation after the first episode of acute pulmonary embolism. Thrombosis Research 122:1, 21-25
CrossRef108
M.G. Bissell. (2008) d-Dimer Testing to Determine the Duration of Anticoagulation Therapy. Yearbook of Pathology and Laboratory Medicine 2008, 374-376
CrossRef109
Samuel Z. Goldhaber. (2008) Doc, is my pulmonary embolism gone?. Thrombosis Research 122:5, 581-583
CrossRef110
William W. Hope, Bradley L. Demeter, William L. Newcomb, Thomas M. Schmelzer, Lynnette M. Schiffern, B. Todd Heniford, Ronald F. Sing. (2007) Postoperative pulmonary embolism: timing, diagnosis, treatment, and outcomes. The American Journal of Surgery 194:6, 814-819
CrossRef111
C. KEARON. (2007) Indefinite anticoagulation after a first episode of unprovoked venous thromboembolism: yes. Journal of Thrombosis and Haemostasis 5:12, 2330-2335
CrossRef112
M. Gómez Antúnez, A. Muiño Míguez, C. Cuenca Carvajal, C. López González-Cobos. (2007) Tromboembolismo pulmonar. Medicine - Programa de Formación Médica Continuada Acreditado 9:90, 5780-5786
CrossRef113
R. L. Silverstein, K. A. Bauer, M. Cushman, C. T. Esmon, W. B. Ershler, R. P. Tracy. (2007) Venous thrombosis in the elderly: more questions than answers. Blood 110:9, 3097-3101
CrossRef114
A. van Hylckama Vlieg, S. C. Christiansen, R. Luddington, S. C. Cannegieter, F. R. Rosendaal, T. P. Baglin. (2007) Elevated endogenous thrombin potential is associated with an increased risk of a first deep venous thrombosis but not with the risk of recurrence. British Journal of Haematology 138:6, 769-774
CrossRef115
Enric Grau, Jos?? Mar??a Ten??as, Mar??a Jos?? Soto, Mar??a Reyes Gutierrez, Ram??n Lecumberri, Jos?? Lu??s P??rez, Gregorio Tiberio. (2007) D-dimer levels correlate with mortality in patients with acute pulmonary embolism: Findings from the RIETE registry. Critical Care Medicine 35:8, 1937-1941
CrossRef116
Miguel A. Ramirez, Lars C. Richardson. (2007) Pulmonary Embolism Associated with Spontaneous Bilateral Achilles Tendon Rupture. The Journal of Foot and Ankle Surgery 46:4, 283-287
CrossRef117
Eric D. Tetzlaff, Arlene M. Correa, Jackie Baker, Joe Ensor, Jaffer A. Ajani. (2007) The impact on survival of thromboembolic phenomena occurring before and during protocol chemotherapy in patients with advanced gastroesophageal adenocarcinoma. Cancer 109:10, 1989-1995
CrossRef118
Mary Cushman. (2007) Epidemiology and Risk Factors for Venous Thrombosis. Seminars in Hematology 44:2, 62-69
CrossRef119
(2007) d-Dimer and Duration of Anticoagulation. New England Journal of Medicine 356:4, 421-423
Full Text120
J. A. Heit. (2007) Thrombophilia: Common Questions on Laboratory Assessment and Management. Hematology 2007:1, 127-135
CrossRef
- Letters
