Low D-dimer cut-off appears to help prevent recurrent events

(HealthDay)—Low cut-off levels used in the D-Dimer-Ultrasonography in Combination Italian Study (DULCIS) resulted in half the recurrent venous thromboembolism (VTE) events that would have occurred using other criteria in young patients at high risk, according to research published online Sept. 12 in the International Journal of Laboratory Hematology.

Gualtiero Palareti, M.D., from the Italian Association of Anticoagulated Patients in Bologna, and colleagues compared the results obtained in the DULCIS with hypothetical results if the following different cut-off criteria were used: traditional cut-off for VTE exclusion, higher levels in subjects aged ≥60 years, or age multiplied by 10.

The researchers found that in young subjects the DULCIS low cut-off levels resulted in half the recurrent events that would have occurred using the other criteria, whereas in elderly patients, the DULCIS results were similar to those calculated for the two age-adjusted criteria. Positive results in the large majority of elderly subjects would have occurred with the adoption of traditional VTE exclusion criteria, without a significant reduction in the rate of recurrent event.

"In conclusion, the present analysis shows that the low cutoff levels adopted in the DULCIS study for young subjects resulted in more young patients who resumed anticoagulation with subsequent increased protection from recurrent events in this population that is at high risk of recurrence," the authors write.

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