Abstract 8748: D-dimer Levels in Combination with Clinical Risk Factors can Effectively Predict Subsequent Thromboembolic Events in Patients with Atrial Fibrillation during Oral Anticoagulation Therapy
Introduction: The aim of the study was to assess whether elevated D-dimer levels in combination with clinical risk factors can predict subsequent thromboembolic events in patients with atrial fibrillation (AF).
Subjects and methods: Consecutive patients with nonvalvular AF (245 patients, 74±9 y/o, 148 paroxysmal AF) treated with warfarin were included. D-dimer levels were measured in combination with clinical risk factors to assess the relationship of this parameter with subsequent thromboembolic events.
Results: D-dimer levels were elevated (≥0.5 µg/ml) in 55 (22%) patients. During an average follow-up time of 756 ± 223 days, 9 (1.8%/year) thromboembolic events occurred. Cox proportional hazard analysis showed that D-dimer levels ≥ 0.5µg/ml was associated with thromboembolic events after adjustment for gender and baseline PT-INR (Hazard ratio 16.6, p<0.01). CHADS2 score ≥3 was also associated with thromboembolic events (Hazard ratio 10.4, p<0.01) and elevated D-dimer levels predicted thromboembolic events in this subgroup (n=76, Hazard ratio 11.0, p=0.029).
Conclusion: CHADS2 scores and D-dimer level can be a useful marker of subsequent thromboembolic events in patients with AF during oral anticoagulation therapy and combination of these can effectively predict thromboembolic events.
- © 2010 by American Heart Association, Inc.