D-Dimer to Predict Recurrent VTE

In patients with initial unprovoked VTE, a negative D-dimer result after short-term anticoagulation might mean that further treatment is unnecessary.

When should anticoagulation be continued after initial treatment of unprovoked venous thromboembolism (VTE) in patients without known risk factors? Investigators conducted a systematic review of seven prospective studies (total of 1888 patients with first unprovoked VTE; follow-up, ≥1 year) in which researchers measured d-dimer levels at 3 weeks to 2 months after anticoagulant therapy was discontinued.

All patients received at least 3 months of anticoagulation treatment before discontinuation. Post-therapy d-dimer results were positive in 907 patients. The annualized risk for recurrent VTE among patients with positive d-dimer results was significantly higher than risk among those with negative d-dimer results (8.9% vs. 3.5%).

Reviewing Author

Richard Saitz, MD, MPH, FACP, FASAM