D-Dimer Measured at Diagnosis of Venous Thromboembolism is Associated with Risk of Major Bleeding
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...
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Georg Thieme Verlag KG
2019
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Online Access: | https://hdl.handle.net/10037/16258 https://doi.org/10.1055/s-0039-1683395 |
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ftunivtroemsoe:oai:munin.uit.no:10037/16258 2023-05-15T18:34:54+02:00 D-Dimer Measured at Diagnosis of Venous Thromboembolism is Associated with Risk of Major Bleeding Johnsen, Håkon Sandbukt Hindberg, Kristian Bjøri, Esben Brodin, Ellen Elisabeth Brækkan, Sigrid Kufaas Morelli, Vania Maris Hansen, John-Bjarne 2019-03-25 https://hdl.handle.net/10037/16258 https://doi.org/10.1055/s-0039-1683395 eng eng Georg Thieme Verlag KG Johnsen, H.S. (2021). Biomarkers of major bleeding after incident venous thromboembolism. (Doctoral thesis). https://hdl.handle.net/10037/20657 . TH Open Johnsen, H.S., Hindberg, K., Bjøri, E., Brodin, E.E., Brækkan, S.K., Morelli, V.M. & Hansen, J.B. (2019). D-Dimer Measured at Diagnosis of Venous Thromboembolism is Associated with Risk of Major Bleeding. TH Open, 3 (1), e77-e84. https://doi.org/10.1055/s-0039-1683395 FRIDAID 1689682 doi:10.1055/s-0039-1683395 2512-9465 https://hdl.handle.net/10037/16258 openAccess VDP::Medical disciplines: 700::Basic medical dental and veterinary science disciplines: 710::Medical biochemistry: 726 VDP::Medisinske Fag: 700::Basale medisinske odontologiske og veterinærmedisinske fag: 710::Medisinsk biokjemi: 726 venous thromboembolism anticoagulants major bleeding D-dimer biomarker Journal article Tidsskriftartikkel Peer reviewed 2019 ftunivtroemsoe https://doi.org/10.1055/s-0039-1683395 2021-06-25T17:56:44Z 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 (1994–2016), who were identified among participants from the Tromsø 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: 4.0–8.2). The major bleeding risk was highest during the first 3 months, especially in patients with D-dimer ≥8.3 µg/mL (upper 20th percentile), with 28.8 major bleedings/100 person-years (95% CI: 13.7–60.4). Patients with D-dimer ≥8.3 µg/mL had a 2.6-fold (95% CI: 1.1–6.6) higher risk of major bleeding than patients with D-dimer ≤2.3 µg/mL (lower 40th percentile). Major bleeding risk according to D-dimer ≥8.3 versus ≤2.3 µg/mL was particularly pronounced among those with deep vein thrombosis (HR: 4.6, 95% CI: 1.3–16.2) and provoked events (HR: 4.2, 95% CI: 1.0–16.8). 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. Article in Journal/Newspaper Tromsø University of Tromsø: Munin Open Research Archive Tromsø TH Open 03 01 e77 e84 |
institution |
Open Polar |
collection |
University of Tromsø: Munin Open Research Archive |
op_collection_id |
ftunivtroemsoe |
language |
English |
topic |
VDP::Medical disciplines: 700::Basic medical dental and veterinary science disciplines: 710::Medical biochemistry: 726 VDP::Medisinske Fag: 700::Basale medisinske odontologiske og veterinærmedisinske fag: 710::Medisinsk biokjemi: 726 venous thromboembolism anticoagulants major bleeding D-dimer biomarker |
spellingShingle |
VDP::Medical disciplines: 700::Basic medical dental and veterinary science disciplines: 710::Medical biochemistry: 726 VDP::Medisinske Fag: 700::Basale medisinske odontologiske og veterinærmedisinske fag: 710::Medisinsk biokjemi: 726 venous thromboembolism anticoagulants major bleeding D-dimer biomarker Johnsen, Håkon Sandbukt Hindberg, Kristian Bjøri, Esben Brodin, Ellen Elisabeth Brækkan, Sigrid Kufaas Morelli, Vania Maris Hansen, John-Bjarne D-Dimer Measured at Diagnosis of Venous Thromboembolism is Associated with Risk of Major Bleeding |
topic_facet |
VDP::Medical disciplines: 700::Basic medical dental and veterinary science disciplines: 710::Medical biochemistry: 726 VDP::Medisinske Fag: 700::Basale medisinske odontologiske og veterinærmedisinske fag: 710::Medisinsk biokjemi: 726 venous thromboembolism anticoagulants major bleeding D-dimer biomarker |
description |
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 (1994–2016), who were identified among participants from the Tromsø 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: 4.0–8.2). The major bleeding risk was highest during the first 3 months, especially in patients with D-dimer ≥8.3 µg/mL (upper 20th percentile), with 28.8 major bleedings/100 person-years (95% CI: 13.7–60.4). Patients with D-dimer ≥8.3 µg/mL had a 2.6-fold (95% CI: 1.1–6.6) higher risk of major bleeding than patients with D-dimer ≤2.3 µg/mL (lower 40th percentile). Major bleeding risk according to D-dimer ≥8.3 versus ≤2.3 µg/mL was particularly pronounced among those with deep vein thrombosis (HR: 4.6, 95% CI: 1.3–16.2) and provoked events (HR: 4.2, 95% CI: 1.0–16.8). 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. |
format |
Article in Journal/Newspaper |
author |
Johnsen, Håkon Sandbukt Hindberg, Kristian Bjøri, Esben Brodin, Ellen Elisabeth Brækkan, Sigrid Kufaas Morelli, Vania Maris Hansen, John-Bjarne |
author_facet |
Johnsen, Håkon Sandbukt Hindberg, Kristian Bjøri, Esben Brodin, Ellen Elisabeth Brækkan, Sigrid Kufaas Morelli, Vania Maris Hansen, John-Bjarne |
author_sort |
Johnsen, Håkon Sandbukt |
title |
D-Dimer Measured at Diagnosis of Venous Thromboembolism is Associated with Risk of Major Bleeding |
title_short |
D-Dimer Measured at Diagnosis of Venous Thromboembolism is Associated with Risk of Major Bleeding |
title_full |
D-Dimer Measured at Diagnosis of Venous Thromboembolism is Associated with Risk of Major Bleeding |
title_fullStr |
D-Dimer Measured at Diagnosis of Venous Thromboembolism is Associated with Risk of Major Bleeding |
title_full_unstemmed |
D-Dimer Measured at Diagnosis of Venous Thromboembolism is Associated with Risk of Major Bleeding |
title_sort |
d-dimer measured at diagnosis of venous thromboembolism is associated with risk of major bleeding |
publisher |
Georg Thieme Verlag KG |
publishDate |
2019 |
url |
https://hdl.handle.net/10037/16258 https://doi.org/10.1055/s-0039-1683395 |
geographic |
Tromsø |
geographic_facet |
Tromsø |
genre |
Tromsø |
genre_facet |
Tromsø |
op_relation |
Johnsen, H.S. (2021). Biomarkers of major bleeding after incident venous thromboembolism. (Doctoral thesis). https://hdl.handle.net/10037/20657 . TH Open Johnsen, H.S., Hindberg, K., Bjøri, E., Brodin, E.E., Brækkan, S.K., Morelli, V.M. & Hansen, J.B. (2019). D-Dimer Measured at Diagnosis of Venous Thromboembolism is Associated with Risk of Major Bleeding. TH Open, 3 (1), e77-e84. https://doi.org/10.1055/s-0039-1683395 FRIDAID 1689682 doi:10.1055/s-0039-1683395 2512-9465 https://hdl.handle.net/10037/16258 |
op_rights |
openAccess |
op_doi |
https://doi.org/10.1055/s-0039-1683395 |
container_title |
TH Open |
container_volume |
03 |
container_issue |
01 |
container_start_page |
e77 |
op_container_end_page |
e84 |
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1766219881311633408 |