Low D-dimer levels at diagnosis of venous thromboembolism are associated with reduced risk of recurrence: data from the TROLL registry

Background: Venous thromboembolism (VTE) is a frequent disease with a high risk of recurrence. It has been suggested that the D-dimer level at the time of VTE diagnosis can be used to identify patients at a low risk of recurrence.Objectives: We aimed to investigate the impact of D-dimer levels measured at the time of VTE diagnosis on the risk of recurrence in a large cohort of patients with a first-time VTE.Methods: The study included 2585 patients with first symptomatic non-cancer-associated VTE from the Venous Thrombosis Registry in ostfold Hospital (TROLL) (20052020). All recurrent events during the follow-up were recorded, and cumulative incidences of recurrence were estimated according to D-dimer levels of =1900 ng/mL (=25th percentile) and >1900 ng/mL.Results: During a median follow-up of 3.3 years, 395 patients experienced a recurrent VTE. The 1- and 5-year cumulative incidences of recurrence were 2.9% (95% CI: 1.84.6) and 11.4% (95% CI: 8.7-14.8), respectively, in those with a D-dimer concentration of =1900 ng/mL and 5.0% (95% CI, 4.0-6.1) and 18.3% (95% CI: 16.2-20.6), respectively, in those with a D-dimer concentration of >1900 ng/mL, respectively. In patients with unprovoked VTE, the 5-year cumulative incidence was 14.3% (95% CI: 10.3-19.7) in the =1900-ng/mL category, and 20.2% (95% CI: 17.3-23.5) in the >1900-ng/mL category.Conclusions: D-dimer levels within the lowest quartile, measured at the time of VTE diagnosis, were associated with lower recurrence risk. Our findings imply that D-dimer levels measured at the time of diagnosis may be used to identify patients with VTE at a low risk of recurrent VTE.

Automated summary

This study investigated the impact of D-dimer levels measured at the time of VTE diagnosis on the risk of recurrence in patients with a first-time VTE. The findings showed that patients with lower D-dimer levels at the time of VTE diagnosis had a lower risk of recurrence, suggesting that D-dimer levels measured at diagnosis can be used to identify patients at a low risk of recurrent VTE.