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High D-dimer plasma concentration in systemic sclerosis patients: Prevalence and association with vascular

Sofia Furtado1,2, Bertrand Dunogué1, Georges Jourdi3,4

  • 1Service de Médecine Interne, Centre de référence des maladies auto-immunes systémiques rares d'Ile-de-France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Descartes, Paris, France.

Journal of Scleroderma and Related Disorders
|April 7, 2022
PubMed

Insights

Elevated D-dimer levels are common in systemic sclerosis patients. These high levels correlate with increased microvascular and macrovascular complications, suggesting D-dimer as a potential risk indicator.

Area of Science:

  • Rheumatology
  • Hematology
  • Vascular Medicine

Background:

  • Systemic sclerosis (SSc) is a complex autoimmune disease characterized by microvascular and macrovascular complications.
  • D-dimer, a marker of coagulation and fibrinolysis, has not been extensively studied in the context of SSc complications.

Purpose of the Study:

  • To determine the frequency of elevated D-dimer plasma concentration in patients with systemic sclerosis.
  • To evaluate the association between elevated D-dimer and SSc-specific microvascular and macrovascular complications.

Main Methods:

  • Retrospective observational study.
  • Analysis of D-dimer levels and clinical data from 214 SSc patients followed between 2010 and 2018.
  • Evaluation of microvascular (digital ulcers, renal crisis, pulmonary arterial hypertension) and macrovascular complications.

Main Results:

  • Elevated D-dimer was observed in 43.5% of SSc patients.
  • Microvascular complications were more frequent in patients with elevated D-dimer, especially after excluding cancer/VTE history (60.5% vs 44.8%, p=0.04).
  • Macrovascular complications were significantly associated with high D-dimer levels (11.8% vs 3.3%, p=0.03), and new events occurred only in this group.

Conclusions:

  • High D-dimer levels are frequent in systemic sclerosis.
  • Elevated D-dimer is associated with both microvascular and macrovascular complications in SSc patients, even after adjusting for confounders.
  • D-dimer may serve as a valuable biomarker for predicting complications in systemic sclerosis.
Abstract

Keywords:
Systemic sclerosismacrovascular complicationsmicrovascular complicationsplasma D-dimers

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