D-dimer levels in patients with thromboangiitis obliterans

Area of Science:

• Vascular Medicine
• Hematology
• Diagnostic Biomarkers

Background:

• Thromboangiitis obliterans (TAO), or Buerger disease, is a progressive vasculopathy affecting small and medium vessels in the limbs.
• The exact cause of TAO is unknown, but tobacco use is strongly associated.
• Clinical diagnosis is challenging due to the lack of a gold standard, especially in atypical cases.

Purpose of the Study:

• To investigate serum D-dimer levels as a potential diagnostic biomarker in patients with TAO.
• To assess the correlation between D-dimer levels and the presence of thrombosis in TAO.
• To explore the potential role of D-dimer in aiding TAO diagnosis and guiding therapeutic decisions.

Main Methods:

• A case-control study involving 62 patients diagnosed with TAO and 330 age- and sex-matched healthy controls.
• Serum D-dimer levels were measured in all participants.
• TAO diagnosis was based on the Shionoya criteria, excluding other risk factors for thrombosis.

Main Results:

• Patients with TAO exhibited significantly higher median D-dimer levels (247 ng/ml) compared to controls (61 ng/ml) (p<0.001).
• All TAO patients were male, with an average age of 40, and had a history of tobacco use.
• Vessel involvement varied, with 85% showing medium-vessel disease and 95% presenting with upper limb or superficial thrombophlebitis.

Conclusions:

• Serum D-dimer levels are considerably elevated in patients with TAO.
• Elevated D-dimer suggests an underlying thrombotic process, supporting its potential as a diagnostic adjunct for TAO.
• The findings hypothesize a potential therapeutic benefit of anticoagulants in managing TAO.