The Journal of Practical Medicine ›› 2022, Vol. 38 ›› Issue (21): 2697-2701.doi: 10.3969/j.issn.1006⁃5725.2022.21.012

• Clinical Research • Previous Articles     Next Articles

Predictive value of D⁃dimer in prevention of PTE after VTE with parenteral anticoagulants

ZHANG Meif⁃ eng，NIE Xiaohong，ZHOU Qian，YANG Zongyan，ZHANG Jianhong，LI Yinyin.   

  1. Department of Respiratory Medi⁃ cine，the Second Affiliated Hospital of Chengdu Medical College（No. 416 Hospital，China National Nuclear Corpo⁃ ration），Chengdu 610051，China 

  • Online:2022-11-10 Published:2022-11-10
  • Contact: NIE Xiaohong E⁃mail：xhnie1226@sina.com

Abstract:

Objective To observe the predictive value of D⁃dimer in the prevention of pulmonary thrombo⁃ embolism（PTE）after venous thromboembolism（VTE）by parenteral anticoagulants. Methods Ninety⁃four patients with high risk of VTE or other conditions with anticoagulant indicators and low risk of bleeding were given parenteral prophylactic anticoagulation for 7 ~ 12 days from May 2020 to June 2021. According to whether with PTE within 6 months after anticoagulation，the patients were divided into PTE group and non⁃PTE group. Age，sex，Padua score， changes of platelet，liver function，renal function and the predictive value of D ⁃ dimer were analyzed. Results Greater age in PTE group（79.09 ± 6.78）was found when compared with that in non⁃PTE group（74.49 ± 10.45） （P < 0.05）. The level of D⁃dimer in PTE group［2 159.5（1 252.25，4 497.75）（μg/L）］was significantly higher than that of non ⁃PTE group［683.5（516，1 172.75）（μg/L）］（P < 0.001）. There were no significant changes in Padua score before anticoagulation，and D⁃dimer，platelet，liver function and renal function before and after anti⁃ coagulation. There was no statistical difference in the above indexes before and after anticoagulation in the non⁃PTE group，but there were changes in platelet，D⁃dimer，aspartate transaminase and creatinine in the non⁃PTE group （P < 0.01 or P < 0.05）. Age was positively correlated with D⁃dimer after anticoagulation（rs = 0.266，P = 0.010）； Padua score was positively correlated with D⁃dimer before and after anticoagulation（rs = 0.520，P < 0.001；rs = 0.236， P = 0.022），and D ⁃ dimer level after anticoagulation was positively correlated with whether with PTE or not（rs = 0.512，P < 0.001）. The area under ROC curve was 0.849（95%CI：0.760 ~ 0.938，P < 0.001）；best cut off value1 026.5 μg/L，with sensitivity and specificity of 90.9%，and 72.2% respectively. Conclusion The level of D⁃dimer after the prevention of VTE by parenteral anticoagulantsin the PTE group does not decrease significantly but is significant higher than that in the non⁃PTE group.High D⁃dimer level has high predictive value for the occurrence of PTEwithin half a year.

Key words:

pulmonary thromboembolism, D ?dimer, parenteral anticoagulants, prevention, pre? dictive value