Elevated D-dimer concentration identifies patients with incomplete recanalization of pulmonary artery thromboemboli despite 6 months anticoagulation after the first episode of acute pulmonary embolism.

摘要: Abstract Background Despite long-term anticoagulation in some patients after acute pulmonary embolism (APE) thrombi are not completely resolved. We hypothesized that elevated D-dimer concentration reflecting increased endogenous fibrinolysis may indicate incomplete resolution the first episode of PE. Methods 55 aged 54.7 ± 18.6 years were anticoagulated for 6 months with acenocumarol (74.5% patients) or low molecular weight heparin (25.5% when control spiral computed tomography (sCT), lung perfusion scintigraphy and assessment performed. Results Incomplete recanalization circulation was found 39 (70.9%) — at sCT and/or ≥ 1 wedge-shaped defect scintigraphy. Age, sex, rate unprovoked APE, malignancies, thrombolysis phase type similar without complete recanalization. follow-up but on admission higher then (median 340 (80–2280) vs 160 (60–390) ng/mL, p  = 0.02). All 11 (20%) level > 500 ng/mL did resolve thromboemboli completely. ROC analysis showed identified (AUC 0.709, 95% CI (0.560–0.831),  = 0.007). Multivariable confirmed > 350 ng/mL right ventricle dysfunction diagnosis independent predictors (OR 18.58 (95% 1.97–175.19) 7.03 1.43–34.6), respectively,  = 0.0006). Conclusion Elevated ventricular predict APE.