<scp>d</scp>-Dimer Testing in Patients With a First Unprovoked Venous Thromboembolism
Authors: Clive Kearon, Scott M. Stevens, Jim A. Julian
Journal: Annals of Internal Medicine (2015)

Letters5 May 2015d-Dimer Testing in Patients With a First Unprovoked Venous ThromboembolismClive Kearon, MB, PhD, Scott M. Stevens, MD, and Jim A. Julian, MMathClive Kearon, MB, PhDFrom Hamilton Health Sciences, Hamilton, Ontario, Canada; Intermountain Medical Center, Murray, Utah; and Ontario Clinical Oncology Group, Hamilton, Ontario, Canada.Search for more papers by this author, Scott M. Stevens, MDFrom Hamilton Health Sciences, Hamilton, Ontario, Canada; Intermountain Medical Center, Murray, Utah; and Ontario Clinical Oncology Group, Hamilton, Ontario, Canada.Search for more papers by this author, and Jim A. Julian, MMathFrom Hamilton Health Sciences, Hamilton, Ontario, Canada; Intermountain Medical Center, Murray, Utah; and Ontario Clinical Oncology Group, Hamilton, Ontario, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5089-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Dr. Palareti's suggestion that exclusion of patients older than 75 years explains the fewer positive d-dimer results in our study than in the 2 earlier studies he mentions (1, 2). Dr. Palareti, however, does not report the proportion of patients younger than 76 years who had positive d-dimer results in their early studies, so this remains uncertain.The recent DULCIS study also had a higher proportion of patients with positive d-dimer results than our study (3). As Dr. Palareti notes, a higher proportion of positive d-dimer results was also present in DULCIS patients younger than ...References1. Cosmi B, Legnani C, Tosetto A, Pengo V, Ghirarduzzi A, Testa S, et al; PROLONG Investigators (on behalf of Italian Federation of Anticoagulation Clinics).. Usefulness of repeated d-dimer testing after stopping anticoagulation for a first episode of unprovoked venous thromboembolism: the PROLONG II prospective study. Blood. 2010;115:481-8. [PMID: 19965693] doi:10.1182/blood-2009-08-237354 CrossrefMedlineGoogle Scholar2. Palareti G, Cosmi B, Legnani C, Tosetto A, Brusi C, Iorio A, et al; PROLONG Investigators.. d-dimer testing to determine the duration of anticoagulation therapy. N Engl J Med. 2006;355:1780-9. [PMID: 17065639] CrossrefMedlineGoogle Scholar3. Palareti G, Cosmi B, Legnani C, Antonucci E, De Micheli V, Ghirarduzzi A, et al; DULCIS (d-dimer and ULtrasonography in Combination Italian Study) Investigators.. d-dimer to guide the duration of anticoagulation in patients with venous thromboembolism: a management study. Blood. 2014;124:196-203. [PMID: 24879813] doi:10.1182/blood-2014-01-548065 CrossrefMedlineGoogle Scholar4. Iorio A, Kearon C, Filippucci E, Marcucci M, Macura A, Pengo V, et al. Risk of recurrence after a first episode of symptomatic venous thromboembolism provoked by a transient risk factor: a systematic review. Arch Intern Med. 2010;170:1710-6. [PMID: 20975016] doi:10.1001/archinternmed.2010.367 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Hamilton Health Sciences, Hamilton, Ontario, Canada; Intermountain Medical Center, Murray, Utah; and Ontario Clinical Oncology Group, Hamilton, Ontario, Canada.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-1275. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee Alsod-Dimer Testing to Select Patients With a First Unprovoked Venous Thromboembolism Who Can Stop Anticoagulant Therapy 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 , and d-Dimer Testing to Select Patients With a First Unprovoked Venous Thromboembolism Who Can Stop Anticoagulant Therapy 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 , and d-Dimer Testing in Patients With a First Unprovoked Venous Thromboembolism Gualtiero Palareti d-Dimer Testing in Patients With a First Unprovoked Venous Thromboembolism Gualtiero Palareti Metrics Cited byPredicting Recurrent VTEA Test in Context: D-DimerResidual pulmonary vascular obstruction and recurrence after acute pulmonary embolism. A single center cohort studyD-dimer levels and recurrence in patients with unprovoked VTE and a negative qualitative D-dimer test after treatment 5 May 2015Volume 162, Issue 9Page: 671KeywordsAnticoagulant therapyD-dimerDisclosureEstrogensMedical risk factorsPatientsPopulation statisticsRisk managementVenous thromboembolism ePublished: 5 May 2015 Issue Published: 5 May 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...