D-DIMER DETERMINATION TO ASSESS REGRESSION OF DEEP VENOUS THROMBOSIS

A number of studies evaluating deep venous thrombosis (DVT) have demon strated that plasma levels of thrombotic and fibrinolytic parameters c hange during treatment, but the relationship between thrombus regressi on and evolution of these markers remains unknown. The objective of th e present study was to correlate levels of D-Dimer (DD) with thrombus regression as assessed by duplex scanning. From 44 patients treated fo r acute DVT, DD were determined at diagnosis and at the end of initial heparin therapy of at least 5 days. Thrombus regression was measured by repeated duplex scanning at diagnosis and after 1 and 3 months. DD significantly decreased during heparin treatment as compared with valu es at presentation. DD levels were significantly higher in the group o f patients without normalization of the DVT after 3 months (p = 0.003) . A ninefold excess tendency was seen for DD levels > 1200 ng/ml at th e end of initial treatment to be associated with poor resolution of th e DVT [odds ratio 9.0, 0.95 confidence interval (CI) 2.3-35.4]. When t he patients with an established malignancy were excluded, the differen ces were even more significant (p = 0.0004 for DD levels after initial treatment and an odds ratio of 17.5, 0.95 CI 3.3-92.5). These results suggest that increased DD levels after the initial phase of treatment are related to poor resolution of DVT after 3 months. These findings contribute to further insight into the process of thrombus regression. Furthermore high DD levels might help to identify the patients with a poor prognosis and could be useful to judge the efficacy of anticoagu lant treatment.