Changes in D-Dimer Levels During Anticoagulation in Patients with Venous Thromboembolism (VTE)

Abstract Background Venous thromboembolism (VTE) is a term including deep vein thrombosis (DVT) and pulmonary embolism (PE). VTE is potentially a fatal disease because of its high morbidity and mortality in outpatients and inpatients, especially in hospitalized patients. Therefore, timely and accurate diagnosis of both is essential as delayed or missed diagnoses can result in death or longer-term complications. At the same time, the lack of subjective clinical symptoms and objective clinical signs complicates the diagnosis. Objective To assess the influence of oral anticoagulants on D-dimer levels in patients with VTE. Methods This Cohort study was conducted at Ain Shams University Hospitals, on 50 patients with radiologically confirmed DVT attending Ain Shams University Hospitals outpatient clinics from September 2021 until March 2022. Results To the comparison of the absolute values of D-dimer levels in the patients’ plasma, we correlated the frequencies of D-dimer levels above cut-off value in the studied patients. For this analysis, D-dimer levels ≥ 0.50 mg/l were defined as cut-off. D-dimer levels above this cut-off were statistically significantly higher in patients on DOACs (direct oral anticoagulant) which are Rivaroxaban and Apixaban than in vitamin K-antagonists (VKA) users after 30 days, with a p value of 0.042. Conclusion Our study reveals that the rate of positive D-dimer levels assessed serially during anticoagulation (at days 14 and 30 post anticoagulation) was significantly higher in patients treated with DOACs than warfarin. This may highlight the value of extended anticoagulation for patients who present with persistently elevated D-dimer levels to avoid the risk of VTE recurrence.