D-dimer assays in patients with carotid atherosclerosis in clinical practice

Background. Correlate D-dimer plasma values with the presence and degree of severity of atherosclerotic carotid lesions in consecutive outpatient and hospitalized patients without cardiovascular symptoms, checking to see if such correlation, if any, may be of help in daily clinical practice. Methods. 113 consecutive outpatient and hospitalized patients (M/F 69/44; mean age±SD 66±11 years). Exclusion criteria: acute arterial and venous thrombo-embolism, chronic venous insufficiency of lower limbs, active infections or inflammatory conditions, neoplasms, recent trauma or surgery. Ultrasonography of epiaortic vessels and quantitative assay of D-dimer using the ELFA method (Enzyme-Linked Fluorescent Assay) were carried out. Results. The patients with carotid lesions at high thrombo-embolic risk had significantly higher D-dimer concentrations than those with normal IMT or with carotid presentation at low risk (1155±1099 ng/ml vs 359±121 ng/ml and 638±468 ng/ml; ANOVA p<0.001). Among the patients at high thrombo-embolic risk, 85% had values higher than cut-off (vs 11.5% of patients with normal IMT and vs 45.5% of patients at low thromboembolic risk). Conclusions. D-dimer assay is a sound means for the study of angiology patients; normal D-dimer concentrations combined with modest lesions in the arterial wall are typical of patients at low thromboembolic risk. Monitoring this parameter may be useful between ultrasound tests. Significant increases over baseline values would prompt clinical intervention and justify additional diagnostic tests.