D-Dimer and thrombus burden in acute pulmonary embolism

Area of Science:

• Cardiology
• Pulmonary Medicine
• Diagnostic Biomarkers

Background:

• Thrombus burden in pulmonary embolism (PE) is linked to increased D-Dimer levels and poorer prognosis.
• Investigating the impact of right ventricular dysfunction (RVD), deep venous thrombosis (DVT), and high-risk PE status on D-Dimer levels is crucial.
• Assessing the efficacy of D-Dimer in predicting RVD among normotensive PE patients is a key objective.

Purpose of the Study:

• To determine the relationship between thrombus burden, RVD, DVT, and D-Dimer levels in PE patients.
• To evaluate the predictive value of D-Dimer for RVD in normotensive PE patients.

Main Methods:

• Retrospective analysis of 161 PE patients, categorized into five thrombus burden subgroups.
• Linear regression models were used to assess the association between D-Dimer levels and thrombus burden.
• Receiver Operating Characteristic (ROC) curve analysis was performed to determine D-Dimer's effectiveness in predicting RVD in 129 normotensive patients.

Main Results:

• D-Dimer levels showed a significant association with thrombus burden categories (univariate analysis, P=.043).
• In normotensive patients, higher D-Dimer levels were observed in those with RVD (1.73 mg/l) compared to those without (1.17 mg/l, P=.049).
• A D-Dimer cut-off of 1.18 mg/l predicted RVD with an Area Under the Curve (AUC) of 0.61 (P=.017).

Conclusions:

• Elevated D-Dimer levels are associated with increased thrombus burden in PE.
• D-Dimer levels >1.18 mg/l are predictive of RVD in normotensive PE patients.
• DVT influences D-Dimer levels, while cancer, pneumonia, age, and renal impairment do not significantly affect them.