D-dimer levels in combination with clinical risk factors can effectively predict subsequent thromboembolic events in patients with atrial fibrillation during oral anticoagulant therapy

Tsuneaki Sadanaga, Shun Kohsaka, Satoshi Ogawa

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objectives: Atrial fibrillation (AF) is associated with hemostatic abnormality and increased risk of thromboembolic events. The aim of the present study was to evaluate whether elevated D-dimer levels in combination with clinical risk factors can adequately predict subsequent thromboembolic events in patients with AF. Method: This was a post hoc analysis of the single-center, prospective observational study. Consecutive patients with nonvalvular AF (245 patients, 74 ± 9 years) treated with warfarin were included. D-dimer levels were measured in combination with clinical risk factors to assess the relationship of this parameter with subsequent thromboembolic events. Results:D-dimer levels were elevated (≥0.5 μg/ml) in 55 (22%) patients. During an average follow-up time of 756 ± 223 days, 9 (1.8%/year) thromboembolic events occurred. Cox proportional hazard analysis showed that elevated D-dimer levels (hazard ratio, HR, 14.3, p < 0.01) as well as high CHADS2 score (≥3; HR 9.43, p < 0.01) was associated with thromboembolic events. C-statistic improved to 0.848 from 0.781 when D-dimer level was added to the predictor model based on CHADS2 score. Elevated D-dimer levels also predicted thromboembolic events in the subgroup of patients with high CHADS2 score (n = 76, HR 12.1, p = 0.021). Conclusion: CHADS2 scores and D-dimer level can be a useful marker of subsequent thromboembolic events in patients with AF during oral anticoagulant therapy and combination of these can effectively predict thromboembolic events.

Original languageEnglish
Pages (from-to)31-36
Number of pages6
JournalCardiology
Volume117
Issue number1
DOIs
Publication statusPublished - 2010 Oct 1

Keywords

  • Atrial fibrillation
  • CHADS score
  • D-dimer
  • Thromboembolism

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)

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