D-dimer to Predict Recurrence in Patients With Multiple Episodes of Venous Thromboembolism
Status:
Terminated
Trial end date:
2011-05-01
Target enrollment:
Participant gender:
Summary
Optimal duration of oral anticoagulant therapy in patients with recurrent episodes of venous
thromboembolism (VTE) is a matter of debate and recommendations are based on inadequate
evidence. More than 12 months of treatment are currently recommended, and the grade of
recommendation is low.
The PROLONG study has recently evaluated the predictive role of D-dimer measurement after
withholding oral anticoagulant treatment in patients with a first episode of VTE. Patients
with a positive D-dimer had a significantly higher incidence of VTE recurrences than patients
with a negative D-dimer and required resumption of the antithrombotic treatment. Based on the
results of this and of previous cohort studies, it appears safe to withhold treatment in
patients with negative D-dimer values and to continue treatment in patients with altered
D-dimer levels.
Aim of this study is therefore to assess the negative predictive value of D-dimer also in
patients with recurrent VTE and to evaluate the clinical utility of this approach in this
patient setting.