Fibrin fragment D-dimer and the risk of future venous thrombosis.

Plasma D-dimer concentration rises more than 100-fold during acute deep vein thrombosis, but there are no prospective data concerning D-dimer as a risk factor for incident venous thrombosis in a general population. Incident venous thrombosis was ascertained in 2 prospective observational studies, the Atherosclerosis Risk in Communities Study and the Cardiovascular Health Study. Of 21 690 participants enrolled between 1987 and 1993, after 8 years of follow-up, D-dimer was measured using baseline stored plasma of 307 participants who developed venous thrombosis and 616 who did not. Relative to the first quintile of the distribution of D-dimer, the age-adjusted odds ratios for future venous thrombosis for the second to fifth quintiles of D-dimer were 1.6, 2.3, 2.3, and 4.2, respectively (P for trend <.0001 following="" added="" adjustment="" for="" sex="" race="" body="" mass="" index="" factor="" v="" leiden="" prothrombin="" and="" elevated="" viii="" coagulant="" activity="" viii:c="" these="" odds="" ratios="" were="" respectively="" trend="" among="" those="" with="" idiopathic="" thrombosis="" or="" secondary="" unrelated="" to="" cancer="" the="" adjusted="" fifth="" quintile="" respectively.="" by="" contrast="" d-dimer="" in="" versus="" first="" was="" not="" related="" occurrence="" of="" cancer-associated="" ratio="" consistently="" subgroups="" defined="" age="" duration="" follow-up="" type="" vein="" pulmonary="" embolus="" is="" strongly="" positively="" future="" venous="" thrombosis.="">