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d-dimer may predict poor outcomes in patients with aneurysmal subarachnoid hemorrhage: a retrospective study

Neural Regeneration Research 2017年第12期12卷 2014-2020页

作者： Jun-hui Liu Xiang-kui Li Zhi-biao Chen Qiang Cai Long Wang Ying-hu Ye Qian-xue Chen department of Neurosurgery Renmin Hospital of Wuhan University department of Neurosurgery Affiliated Hospital of Shandong Medical College

Serum biomarkers may play a reliable role in predicting the outcomes of patients with aneurysmal subarachnoid hemorrhage. This study retrospectively analyzed the relationship between serum biomarkers on admission and outcomes in patients with aneurysmal subarachnoid hemorrhage. We recruited 146 patients with aneurysmal subarachnoid hemorrhage who were treated in Renmin Hospital of Wuhan University of China between 1 May 2014 and 30 March 2016. There were 57 males and 89 females included and average age of included patients was 57.03 years old. Serum samples were taken immediately on admission（within 48 hours after initial hemorrhage） and the levels of serum biomarkers were detected. Baseline information, complications, and outcomes at 6 months were recorded. Univariate and multivariate logistic regression analyses were used to explore the relationship between biomarkers and clinical outcomes. Receiver operating characteristic curves were obtained to investigate the possibility of the biomarkers predicting prognosis. Of the 146 patients, 102 patients achieved good outcomes and 44 patients had poor outcomes. Univariate and multivariate analyses showed that high World Federation of Neurosurgical Societies grade, high serum d-dimer levels, and high neurological complications were significantly associated with poor outcomes. Receiver operating characteristic curves verified that d-dimer levels were associated with poor outcomes. d-dimer levels strongly correlated with neurological complications. In conclusion, we suggest that d-dimer levels are a good independent prognostic factor for poor outcomes in patients with aneurysmal subarachnoid hemorrhage.

关键词： nerve regeneration aneurysmal subarachnoid hemorrhage d-dimer serum biomarkers complications prognosis logistic regressionanalysis neural regeneration

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d-dimer level and long-term outcome in patients with end-stage heart failure secondary to idiopathic dilated cardiomyopathy

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Journal of Geriatric Cardiology 2019年第8期16卷 621-629页

作者： Bi HUANG Yuan-Jing LI Jian SHEN Yuan YANG Gang LIU Su-Xin LUO department of Cardiology the First Affiliated Hospital of Chongqing Medical University

Background Previous studies had demonstrated hemostatic abnormalities in patients with heart failure (HF) and several studies have shown that abnormal coagulation indices, represented by elevated d-dimer, had prognostic significance in patients with compatible or acute decompensated HF. However, the impact of d-dimer on the outcome in patients with end-stage HF remains unclear. Methods A total of 244 consecutive patients with end-stage HF due to idiopathic dilated cardiomyopathy (dCM) were prospectively enrolled from February 2011 to September 2014. d-dimer levels were measured and its prognostic value was assessed. Primary endpoint was all-cause mortality during the follow-up period. Secondary endpoints were stroke, bleeding, occurrence of sustained ventricular tachycardia or ventricular fibrillation, and major adverse cardiovascular events (MACE). Results d-dimer was significantly elevated in the non-survivors (median: 0.8 vs. 1.1 mg/L, P ditional markers including B-type natriuretic peptide, troponin I, left ventricular ejection fraction, and left ventricular end-diastolic dimension provided limited prognostic value;but the addition of d-dimer refined the risk stratification. The optimal cut-off value of d-dimer to predict all-cause mortality was 0.84 mg/L by receiver operator characteristic analysis. Elevated d-dimer level was independently associated with increased risk of long-term all-cause mortality (HR = 2.315, 95% CI: 1.570–3.414, P d MACE (HR = 1.256, 95% CI: 1.058–1.490, P = 0.009), and the predictive value was independent of age, sex, atrial fibrillation and anticoagulation status. Conclusions Elevated d-dimer level was independently associated with poor long-term outcome in patients with end-stage HF secondary to idiopathic dCM, and the predictive value was superior to that of traditional prognostic markers.

关键词： d-dimer End-stage heart failure Idiopathic dilated cardiomyopathy Long-term outcome

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Coagulopathy and the prognostic potential of d-dimer in hyperlipidemia-induced acute pancreatitis

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Hepatobiliary & Pancreatic diseases International 2015年第6期14卷 633-641页

作者： Ning Yang dong-Lei Zhang Jian-Yu Hao department of Endocrinology Beijing Chaoyang HospitalCapital Medical University department of Gastroenterology Beijing Chaoyang HospitalCapital Medical University

BACKGROUNd： Coagulopathy and its association with disease severity in hyperlipidemia （HL）- and non-hyperlipidemia （NHL）-induced acute pancreatitis （AP） are not dear. The present study was to evaluate the relati... 详细信息

关键词： hyperlipidemia-induced acute pancreatitis coagulation homeostasis d-dimer protein C disease severity

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d-dimer is useful in assessing the vulnerable blood in elderly patients with coronary disease

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Journal of Geriatric Cardiology 2008年第3期5卷 131-136页

作者： Yansong Zheng Qiang Zeng Liping Zhang Liufa duan Kunlun He Qiufu Zheng department of Geriatircs, General Hospital of Chinese PLA, Beijing 100853, China. department of Geriatircs General Hospital of Chinese PLA Beijing 100853 China

Background and objective The value of d-dimer in the risk stratification of patients with coronary artery disease(CAd) and the relationship between d-dimer and the diseased coronary arteries remains controversial or unclear,especially in the *** study was to evaluate the usefulness of d-dimer as a biomarker in assessing the vulnerable blood in the elderly patients with coronary *** Sixty elderly (≥60 years old) male patients with suspected CAd were enrolled in this prospective study. Patients were divided into CAd group (n=41,10 with stable angina and 31 with unstable angina) and control group (n=19) according to their coronary angiography Results Clinical information including age,body mass index (BMI),smoking index,and the complications of primary hypertension or diabetes,and CAd family history was *** blood was sampled serially for the determination of total cholesterol,HdL cholesterol,LdL cholesterol,triglycerides,apoA1,apoB,glucose,uric acid,homocysteine (Hcy),hs-CRP,soluble thrombomodulin (sTM),and markers of fibrinolytic system and hypercoagulability,such as d-dimer,fibrinogen, *** extent of coronary atherosclerosis was assessed,using the Gensini scoring system on the basis of coronary angiography. Results Compared with the controls,the patients with CAd had significantly higher levels of d-dimer.d-dimer level was significantly correlated to age,hs-CRP,Hcy,and *** with d-dimer levels in the top triplicate of d-dimer level had significantly higher prevalence of unstable angina compared with patients in the lowest triplicate (OR=4.8,Z=3.28,P=0.001).In an ordinal logistic regression,the OR value of developing more serious CAd augmented 3.1-fold with each increasing triplicate of d-dimer. Patients with unstable angina had a significantly higher level of d-dimer than the controls (P=0.005),and an increasing trend compared with patients with stable angina (P=0.059),whereas there was no difference between the patients

关键词： coronary artery disease coagulation fibrinolysis d-dimer inflammation atherosclerosis

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Incidence of venous thromboembolism and the role of d-dimer as predictive marker in patients with advanced gastric cancer receiving chemotherapy:A prospective study

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World Journal of Gastrointestinal Oncology 2017年第4期9卷 176-183页

作者： Kwonoh Park Baek-Yeol Ryoo Min-Hee Ryu Sook Ryun Park Myoung Joo Kang Jeong Hye Kim Seungbong Han Yoon-Koo Kang Medical Oncology and Hematology Department of Internal medicinePusan National University Yangsan Hos-pital department of Oncology Asan Medical CenterUniversity of Ulsan College of Medicine department of Clinical Epidemiology and Biostatics Asan Medical CenterUniversity of Ulsan College of Medicine

To investigated the incidence and risk factors of venous thromboembolism (VTE) in patients with advanced gastric cancer (AGC) receiving chemotherapy. METHOdSAll consecutive chemotherapy-naïve patients with AGC who would receive palliative chemotherapy between November 2009 and April 2012 in our hospital were recruited. Their pretreatment clinical and laboratory variables, including d-dimer, were recorded. The frequency of VTE development and survival rates during each chemotherapy cycle and regularly thereafter were assessed. RESULTSA total of 241 patients enrolled between November 2009 and April 2012 were analyzed. during a median follow-up duration of 10.8 mo (95%CI: 9.9-11.7), 27 patients developed VTE and the incidence of VTE was 17.5% (95%CI: 10.5-24.0, 12.0 events/100 person-years). The 6-mo and 1-year cumulative incidences were 7.8% (95%CI: 4.2%-11.4%) and 12.4% (95%CI: 7.3-17.2), respectively. Thirteen (48.1%) patients were symptomatic and the other 14 (51.9%) patients were asymptomatic. In multivariate analysis, pretreatment d-dimer level was the only marginally significant risk factor associated with VTE development (hazard ratio = 1.32; 95%CI: 1.00-1.75, P = 0.051). CONCLUSIONThe incidence of VTE is relatively high in patients with AGC receiving chemotherapy, and pretreatment d-dimer level might be a biomarker for risk stratification of VTE.

关键词： Advanced gastric cancer d-dimer Venous thromboembolism

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Predictive value of d-dimer for portal vein thrombosis after portal hypertension surgery in hepatitis B virus-related cirrhosis

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World Journal of Gastroenterology 2007年第48期13卷 6588-6592页

作者： Mei-Hai deng Bo Liu He-Ping Fang Wei-dong Pan Zhao-Feng Tang Peng deng Yue-Si Zhong Rui-Yun Xu department of Hepato-biliary Surgery Third Affiliated Hospital Sun Yat-Sen University Guangzhou 510630 Guangdong Province China

AIM: To evaluate the predictive value of d-dimer as a predictive indicator of portal vein thrombosis (PVT) after portal hypertension surgery in hepatitis B virus-related cirrhosis. METHOdS: A prospective study was carried out in 52 patients who had undergone surgery for portal hypertension in hepatitis B virus-related cirrhosis. Changes in perioperative dynamic d-dimer were observed. The sensitivity, specifi city, positive predictive values and negative predictive values of d-dimer were calculated, and ROC curves were analyzed. RESULTS: The d-dimer levels in the group developing postoperative PVT was signifi cantly higher than those in the group not developing PVT (P = 0.001), and the ROC semi-quantitative and qualitative analysis of d-dimer showed a moderate predictive value in PVT (semi- quantitative value Az = 0.794, P = 0.000; qualitative analysis: Az = 0.739, P = 0.001). CONCLUSION: dynamic monitoring of d-dimer levels in patients with portal hypertension after surgery can help early diagnosis of PVT, as in cases where the d-dimer levels steadily increase and exceed 16 μg/mL, the possibility of PVT is very high.

关键词： Portal hypertension Portal vein thrombosis Splenectomy d-dimer diagnosis

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Elevated preoperative plasma d-dimer dose not adversely affect survival of gastric cancer after gastrectomy with curative intent: A propensity score analysis

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Chinese Journal of Cancer Research 2018年第2期30卷 254-262页

作者： Yuexiang Liang donglei He Liangliang Wu Xuewei ding Xiaona Wang Baogui Wang Rupeng Zhang Han Liang department of Gastrointestinal Oncology the First Affiliated Hospital of Hainan Medical College department of Gastric Cancer Tianjin Medical University Cancer Institute & Hospital National Clinical Research Center of Cancer Tianjin's Clinical Research Cancer for Cancer Key Laboratory of Cancer Prevention and Therapy

Objective： Elevated plasma d-dimer has been reported to be associated with advanced tumor stage and poor survival in several types of malignancies. The purpose of this study was to assess the potential impact of preoperative plasma d-dimer level（PdL） on overall survival（OS） of gastric cancer（GC） patients undergoing curative surgery by applying propensity score ***： A total of 1,025 curatively resected GC patients in Tianjin Medical University Cancer Institute ＆Hospital were enrolled. Patients were categorized into two groups based on preoperative PdL： the elevated group（EG） and the normal group（NG）. To overcome bias due to the different distribution of covariates for the two groups, a one-to-one match was applied using propensity score analysis, after matching, prognostic factors were ***： In analysis for the whole study series, patients in the EG were more likely to have a larger proportion of tumor size ≥5 cm（67.5% vs. 55.8%, P=0.006）, elder mean age（64.0±10.8 years vs. 60.5±11.6 years, P〈0.001） and advanced tumor（T）, node（N）, and TNM stage. Patients with elevated PdL demonstrated a significantly lower 5-year OS than those with normal PdL（27.0% vs. 42.6%, P〈0.001）, however, the PdL was not an independent prognostic factor for OS in multivariate analysis [hazard ratio： 1.13, 95% confidence interval（95% CI）： 0.92–1.39,P=0.236]. After matching, 163 patients in the EG and 163 patients in the NG had the same characteristics. The 5-year OS rate for patients in the EG was 27.0% compared with 25.8% for those in the NG（P=0.809, log-rank）.Conclusions： The poor prognosis of GC patients with elevated preoperative PdL was due to the advanced tumor stage and elder age rather than the elevated d-dimer itself.

关键词： Gastric carcinoma d-dimer prognosis

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Prognostic value of fibrinogen and d-dimer-fibrinogen ratio in resectable gastrointestinal stromal tumors

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World Journal of Gastroenterology 2018年第44期24卷 5046-5056页

作者： Hua-Xia Cai Xu-Qi Li Shu-Feng Wang department of General Surgery First Affliated Hospital of Xi'an Jiaotong University Xi'an 710061 Shaanxi Province China department of General Surgery Xi'an 141 Hospital Yanliang 710089 Shaanxi Province China

AIM To investigate the prognostic value of preoperative fbri-nogen concentration （FIB） and d-dimer-fibrinogen ratio （dFR） in gastrointestinal stromal tumors （GISTs）.METHOdS The purpose of this study was to retrospectively ana-lyze 170 patients with GISTs who were admitted to our hospital from January 2010 to december 2015. The op-timal cutoff values of related parameters were estimated by receiver operating characteristic （ROC） curve analysis. The recurrence free survival （RFS） rate was evaluated using Kaplan-Meier curves. Univariate analysis and multivariate Cox regression models were used to analyze the prognostic factors of GISTs. The relationship between the FIB, d-dimer, dFR, platelet count （PLT）, and the clinicopathological features of GISTs was described by the chi-square test or nonparametric rank sum test （Mann-Whitney test）.RESULTS In ROC analysis, the optimal cutoff values of FIB, d-dimer, dFR, and PLT were 3.24 g/L, 1.24 mg/L, 0.354, and 197.5 （× 109/L）, respectively. Univariate analysis and the Kaplan-Meier survival curve showed that FIB, d-dimer, dFR, PLT,National Institutes of Health （NIH） risk category, tumor size, tumor location, and mitotic index were signifcantly relevant to the 3-year and 5-year survival rate of patients （ P 〈 0.05）. Cox multivariate regression analysis illustrated that FIB （RR： 0.108, 95%CI： 0.031-0.373）, dFR （RR： 0.319, 95%CI： 0.131-0.777）, and NIH risk category （ RR： 0.166, 95%CI： 0.047-0.589） were independent prognostic factors of the RFS rate （ P 〈 0. 05）. Moreover, FIB, d-dimer, dFR, and PLT were correlated with the clinical features of ***, d-dimer, dFR, and PLT are all related to the prognosis of GISTs. Moreover, FIB and dFR may be independent risk factors for predicting the prognosis of resectable GISTs.

关键词： d-dimer d-dimer-fbrinogen ratio Prognosis Fibrinogen Gastrointestinal stromal tumor

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Clinical laboratory investigation of a patient with an extremely high d-dimer level:A case report

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World Journal of Clinical Cases 2020年第16期8卷 3560-3566页

作者： Han-Xiao Sun Hong Ge Zhong-Qing Xu Hui-Ming Sheng department of Laboratory Medicine Tongren HospitalShanghai Jiao Tong University School of MedicineShanghai 200336China department of General Practice Tongren HospitalShanghai Jiao Tong University School of MedicineShanghai 200336China

BACKGROUNd d-dimer,a soluble degradation product of cross-linked fibrin,is commonly used as an important marker for the diagnosis of disseminated intravascular coagulation and differential diagnosis of ***,we present a geriatric case with an unusually elevated d-dimer *** SUMMARY An 82-year-old woman,admitted to the ward with a diagnosis of chronic heart failure,was noted to have a remarkably elevated d-dimer level,beyond the qualified range(>100 mg/L),utilizing the Innovating d-dimer for Sysmex CS-5100 System?.However,no evidence,including clinical symptoms,radiographic evidence of thromboembolic disease,and parallel fibrinogen degradation product values,suggested that this patient was at high risk of *** confirm the discrepancy,a series of approaches including sample dilution,re-analysis via alternative methods,and sample treatment with blockage of specific heterophilic antibodies were performed.A remarkable disappearance of the elevated d-dimer values was observed in the samples after they were subjected to these approaches(4.49,9.42,9.06,and 12.58 mg/L,respectively).This confirmed the presence of heterophilic antibodies in this *** addition,a reduction in cardiac output due to the presence of cardiac failure could also be responsible for the existence of a hypercoagulable state in this *** In conclusion,the presence of heterophilic antibodies should be considered when an elevated d-dimer value is not in conformity with the clinical evidence,and a viral infection should be considered when interference by a heterophilic antibody exists.

关键词： d-dimer Heterophilic antibodies Epstein-Barr virus Case report

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Prognostic Value of d-dimer in Patients with diffuse Large B-cell Lymphoma:A Retrospective Study

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Current Medical Science 2019年第2期39卷 222-227页

作者： Yu-di GENG Yi-ren CHEN Jin JIN Xiao-di WANG Shu ZHANG deng-ju LI department of Hematology Tongji HospitalTongji Medical CollegeHua zhong University of Science and TechnologyWuhan 430030China College of Mathematics and Statistics Shenzhen UniversityShenzhen 518060China

This study evaluated the significance of serum d-dimer for predicting survival of patients with diffuse large B-cell lymphoma(dLBCL).We analyzed the clinical data from 113 patients who were newly diagnosed with dLBCL at Tongji Hospital from January 2012 to January *** results indicated that there were higher levels of d-dimer in dLBCL patients with the following characteristics:stage HI/IV,lymphocyte monocyte ratio(LMR)dehydrogenase(LdH)>upper limit of normal(ULN),albumin(ALB)d *** the first chemotherapeutic regimen,d-dimer was significantly decreased concomitantly with *** univariate regression analysis showed that the overall survival(OS)was negatively affected by the following factors:age>60 years,stage m/IV,LdH>ULN,LMRd d-dimer>*** analysis showed that only LdH>ULN(P=0.038)and age>60 years(P=0.047)were independent adverse prognostic ***,it was suggested that d-dimer could be regarded as a marker of high tumor burden and a potential prognostic screening tool for patients with dLBCL,not otherwise specified(NOS).

关键词： diffuse large B-cell lymphoma d-dimer prognosis

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