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. 2019 Jan-Dec:25:1076029619863495.
doi: 10.1177/1076029619863495.

D-Dimer Predicts Disease Severity but Not Long-Term Prognosis in Acute Pulmonary Embolism

Fabian Geissenberger  1 , Florian Schwarz  2   3 , Michael Probst  2 , Sabine Haberl  1 , Stefanie Gruetzner  4 , Thomas Kroencke  2 , Wolfgang von Scheidt  1   3 , Thomas M Berghaus  1   3
Affiliations

D-Dimer Predicts Disease Severity but Not Long-Term Prognosis in Acute Pulmonary Embolism

Fabian Geissenberger et al. Clin Appl Thromb Hemost. 2019 Jan-Dec.

Abstract

D-dimer might be correlated with prognosis in pulmonary embolism (PE). The predictive value of plasma D-dimer for disease severity and survival was investigated in the lowest and highest D-dimer quartile among 200 patients with PE. Patients with high D-dimers were significantly more often hypotensive (P = .001), tachycardic (P = .016), or hypoxemic (P = .001). Pulmonary arterial obstruction index (PAOI) values were significantly higher in the high D-dimer quartile (P < .001). Elevated troponin I (TNI) levels (P < .001), simplified PE severity indices ≥1 (P < .001), right-to-left ventricular (RV/LV) diameter ratios ≥1 (P < .001), and thrombolysis (P = .001) were more frequent in the high D-dimer quartile. D-dimer was associated with RV/LV ratios ≥1 (P = .021), elevated PAOI (P < .001) or TNI levels (P < .001), hypotension (P < .001), tachycardia (P = .003), and hypoxemia (P < .001), but not with long-term all-cause mortality. D-dimer predicts disease severity but not long-term prognosis in acute PE, possibly due to a more aggressive treatment strategy in severely affected patients.

Keywords: D-dimer; disease severity; prognosis; pulmonary embolism; risk stratification.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article

Figures

Figure 1.
Figure 1.
Survival analysis: Kaplan-Meier plot for the low D-dimer (blue) and high D-dimer (red) subgroup.
See this image and copyright information in PMC

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