d-Dimer Testing to Select Patients With a First Unprovoked Venous Thromboembolism Who Can Stop Anticoagulant Therapy

• DOI: 10.7326/m14-1275
• Publication Date: 2015-01-05T23:30:55Z
• Authors: Clive Kearon; Frederick A. Spencer; Denis O'Keeffe; Sameer Parpia; Sam Schulman; Trevor Baglin; Scott M. Stevens; Scott Kaatz; Kenneth A. Bauer; James D. Douketis; Steven R. Lentz; Craig M. Kessler; Stephan Moll; Jean M. Connors; Jeffrey S. Ginsberg; Luciana Spadafora; Jim A. Julian
• Keywords: D-dimer; Anticoagulant Therapy

Normal D-dimer levels after withdrawal of anticoagulant therapy are associated with a reduced risk for recurrence in patients unprovoked venous thromboembolism (VTE) and may justify stopping treatment.To determine whether first VTE negative test result who stop have low recurrence.Prospective management study blinded outcome assessment. (ClinicalTrials.gov: NCT00720915).13 university-affiliated clinical centers.410 adults aged 75 years or younger proximal deep thrombosis pulmonary embolism had completed 3 to 7 months therapy.Anticoagulant was stopped if results were not restarted still 1 month.Recurrent during an average follow-up 2.2 years.In 319 (78%) 2 did restart therapy, rates recurrent 6.7% (95% CI, 4.8% 9.0%) per patient-year overall (42 319), 9.7% (CI, 13.7%) men (33 180), 5.4% 2.5% 10.2%) women estrogen (9 81), 0.0% 3.0%) (0 58) (P = 0.001 the 3-group comparison).Imprecision female subgroups. Results be generalizable different assays from one used study.The is enough but women.Canadian Institutes Health Research.