%0 Journal Article
%T D-Dimer Measured at Diagnosis of Venous Thromboembolism is Associated with Risk of Major Bleeding
%A Ellen E. Brodin
%A Esben Bjˋri
%A Hˋkon S. Johnsen
%A John-Bjarne Hansen
%A Kristian Hindberg
%A Sigrid K. Brˋkkan
%A Vania M. Morelli
%J Archive of "TH Open: Companion Journal to Thrombosis and Haemostasis".
%D 2019
%R 10.1055/s-0039-1683395
%X Identification of patients at risk of major bleeding is pivotal for optimal management of anticoagulant therapy in venous thromboembolism (VTE). Studies have suggested that D-dimer may predict major bleeding during anticoagulation; however, this is scarcely investigated in VTE patients. We aimed to investigate the role of D-dimer, measured at VTE diagnosis, as a predictive biomarker of major bleeding. The study population comprised 555 patients with a first community-acquired VTE (1994每2016), who were identified among participants from the Tromsˋ study. Major bleeding events were recorded during the first year after VTE and defined according to the criteria of the International Society on Thrombosis and Haemostasis. Cox-regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) adjusted for age, sex, and duration of anticoagulant therapy. In total, 29 patients experienced major bleeding (incidence rate: 5.7/100 person-years, 95% CI: 4.0每8.2). The major bleeding risk was highest during the first 3 months, especially in patients with D-dimer ≡8.3 米g/mL (upper 20th percentile), with 28.8 major bleedings/100 person-years (95% CI: 13.7每60.4). Patients with D-dimer ≡8.3 米g/mL had a 2.6-fold (95% CI: 1.1每6.6) higher risk of major bleeding than patients with D-dimer ≒2.3 米g/mL (lower 40th percentile). Major bleeding risk according to D-dimer ≡8.3 versus ≒2.3 米g/mL was particularly pronounced among those with deep vein thrombosis (HR: 4.6, 95% CI: 1.3每16.2) and provoked events (HR: 4.2, 95% CI: 1.0每16.8). In conclusion, our results suggest that D-dimer measured at diagnosis may serve as a predictive biomarker of major bleeding after VTE, especially within the initial 3 months
%K venous thromboembolism
%K anticoagulants
%K major bleeding
%K D-dimer
%K biomarker
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6524911/