Figure 3.
Results from two clinical trials of D-dimer and the risk of recurrent venous thrombosis among patients with idiopathic first events. The PREVENT study randomized patients to low intensity warfarin therapy (target INR 1.5–2.0) and baseline D-dimer elevation was predictive of the risk of recurrent venous thrombosis, regardless of randomized treatment assignment. The lowest rates of recurrence were in the group with low D-dimer on active treatment (67). The PROLONG study was a management study which observed patients with low D-dimer after completing a course of anticoagulation for first thrombosis, and randomized patients with elevated D-dimer to continued anticoagulation or observation. Similar to PREVENT, those with low D-dimer had a lower recurrence risk, and continued anticoagulation was effective in risk reduction among those with elevated D-dimer (70). Pos, positive; neg, negative; OAC, continued long-term oral anticoagulation with vitamin K antagonists.