Usefulness of repeated D-dimer testing after stopping anticoagulation for a first episode of unprovoked venous thromboembolism: The PROLONG II prospective study

Benilde Cosmi, Cristina Legnani, Alberto Tosetto, Vittorio Pengo, Angelo Ghirarduzzi, Sophie Testa, Domenico Prisco, Daniela Poli, Armando Tripodi, Francesco Marongiu, Gualtiero Palareti

Research output: Contribution to journalArticle

Abstract

The PROLONG randomized trial showed that a normal D-dimer (D-d) 1 month after anticoagulation suspension for unprovoked venous thromboembolism (VTE) was associated with a low risk of late recurrences (4.4% patient years). However, it is unknown whether D-d changes subsequently. The aim of this prospective multicenter study was to assess D-d time course and its relation with late recurrences in patients with normal D-d 1 month after anticoagulation suspension for a first episode of unprovoked VTE. D-d was measured with a qualitative method (Clearview Simplify D-dimer; Inverness Medical Professional Diagnostics). Patients with a normal D-d 1 month after stopping anticoagulation repeated D-d testing every 2 months for 1 year. D-d was normal in 68% (243/355) of patients 1 month after anticoagulation suspension. Patients in whom D-d became abnormal at the third month and remained abnormal afterward had a higher risk of recurrence (7/31; 27% patient years; 95% confidence interval [CI]: 12-48) than patients in whom D-d remained normal at the third month and afterward (4/149; 2.9% patient years; 95% CI: 1-7; adjusted hazard ratio: 7.9; 95% CI: 2.1-30; P = .002). Repeated D-d testing after anticoagulation suspension for a first episode of unprovoked VTE could help tailor the duration of treatment. This trial is registered at http://clinicaltrials.gov as NCT00266045.

Original languageEnglish
Pages (from-to)481-488
Number of pages8
JournalBlood
Volume115
Issue number3
DOIs
Publication statusPublished - Jan 21 2010

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Venous Thromboembolism
Prospective Studies
Testing
Suspensions
Confidence Intervals
Recurrence
fibrin fragment D
Multicenter Studies
Hazards

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

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Usefulness of repeated D-dimer testing after stopping anticoagulation for a first episode of unprovoked venous thromboembolism : The PROLONG II prospective study. / Cosmi, Benilde; Legnani, Cristina; Tosetto, Alberto; Pengo, Vittorio; Ghirarduzzi, Angelo; Testa, Sophie; Prisco, Domenico; Poli, Daniela; Tripodi, Armando; Marongiu, Francesco; Palareti, Gualtiero.

In: Blood, Vol. 115, No. 3, 21.01.2010, p. 481-488.

Research output: Contribution to journalArticle

Cosmi, B, Legnani, C, Tosetto, A, Pengo, V, Ghirarduzzi, A, Testa, S, Prisco, D, Poli, D, Tripodi, A, Marongiu, F & Palareti, G 2010, 'Usefulness of repeated D-dimer testing after stopping anticoagulation for a first episode of unprovoked venous thromboembolism: The PROLONG II prospective study', Blood, vol. 115, no. 3, pp. 481-488. https://doi.org/10.1182/blood-2009-08-237354
Cosmi, Benilde ; Legnani, Cristina ; Tosetto, Alberto ; Pengo, Vittorio ; Ghirarduzzi, Angelo ; Testa, Sophie ; Prisco, Domenico ; Poli, Daniela ; Tripodi, Armando ; Marongiu, Francesco ; Palareti, Gualtiero. / Usefulness of repeated D-dimer testing after stopping anticoagulation for a first episode of unprovoked venous thromboembolism : The PROLONG II prospective study. In: Blood. 2010 ; Vol. 115, No. 3. pp. 481-488.
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