Stefan Acosta, Annika Reintam Blaser, Alexandre Nuzzo, Yasmin Soltanzadeh-Naderi, Joel Starkopf, Alastair Forbes, Marko Murruste, Kadri Tamme, Anna-Liisa Voomets, Merli Koitmäe, Miklosh Bala, Zsolt Bodnar, Dumitru Casian, Zaza Demetrashvili, Alan Biloslavo, Virginia Dúran Muñoz-Cruzado, Benjamin Hess, Karri Kase, Mikhail Kirov, Matthias Lindner, Cecilia I Loudet, Dimitrios Damaskos, Martin Björck
{"title":"急性肠系膜静脉血栓形成中的 D-二聚体：一项前瞻性病例对照国际多中心研究。","authors":"Stefan Acosta, Annika Reintam Blaser, Alexandre Nuzzo, Yasmin Soltanzadeh-Naderi, Joel Starkopf, Alastair Forbes, Marko Murruste, Kadri Tamme, Anna-Liisa Voomets, Merli Koitmäe, Miklosh Bala, Zsolt Bodnar, Dumitru Casian, Zaza Demetrashvili, Alan Biloslavo, Virginia Dúran Muñoz-Cruzado, Benjamin Hess, Karri Kase, Mikhail Kirov, Matthias Lindner, Cecilia I Loudet, Dimitrios Damaskos, Martin Björck","doi":"10.1177/11772719241296631","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Acute mesenteric venous thrombosis (MVT) is rarely suspected as primary diagnosis in emergency departments and still carries an in-hospital mortality rate of above 20%.</p><p><strong>Objectives: </strong>The aim of this study was to find differences in clinical and laboratory markers between patients with acute MVT and a control group of suspected but confirmed as not having any type of acute mesenteric ischaemia (AMI).</p><p><strong>Design: </strong>Data was retrieved from the AMESI (Acute MESenteric Ischaemia) study. This international, multicenter prospective case-control study from 32 sites collected data on patients with suspected AMI during a 10-month period.</p><p><strong>Methods: </strong>Independent factors associated with acute MVT were evaluated in a multivariable logistic regression analysis and expressed as odds ratios (OR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>D-dimer was not significantly higher in MVT (n = 73) compared to non-AMI (n = 287) patients (median 7.0 mg/L vs 4.5 mg/L, <i>P</i> = .092). After entering BMI, atherosclerotic disease, history of venous thromboembolism, CRP, and D-dimer as covariates in a multi-variable logistic regression analysis, absence of atherosclerotic disease (OR 0.096, 95% CI 0.011-0.84; <i>P</i> = .034) and elevated D-dimer (OR 2.59/one SD increment, 95% CI 1.07-6.28; <i>P</i> = .034) were associated with MVT. The discriminative ability of D-dimer for MVT as assessed by area under the curve in the receiver operating characteristics analysis was 0.63 (95% CI 0.49-0.78).</p><p><strong>Conclusion: </strong>Elevated D-dimer was associated with MVT, but the discriminative ability of D-dimer was poor. There is an urgent need to find a more accurate plasma biomarker for this condition.</p><p><strong>Trial registration: </strong>NCT05218863 (registered 19.01.2022).</p>","PeriodicalId":47060,"journal":{"name":"Biomarker Insights","volume":"19 ","pages":"11772719241296631"},"PeriodicalIF":3.4000,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590162/pdf/","citationCount":"0","resultStr":"{\"title\":\"D-Dimer in Acute Mesenteric Venous Thrombosis: A Prospective Case-Control International Multicenter Study.\",\"authors\":\"Stefan Acosta, Annika Reintam Blaser, Alexandre Nuzzo, Yasmin Soltanzadeh-Naderi, Joel Starkopf, Alastair Forbes, Marko Murruste, Kadri Tamme, Anna-Liisa Voomets, Merli Koitmäe, Miklosh Bala, Zsolt Bodnar, Dumitru Casian, Zaza Demetrashvili, Alan Biloslavo, Virginia Dúran Muñoz-Cruzado, Benjamin Hess, Karri Kase, Mikhail Kirov, Matthias Lindner, Cecilia I Loudet, Dimitrios Damaskos, Martin Björck\",\"doi\":\"10.1177/11772719241296631\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Acute mesenteric venous thrombosis (MVT) is rarely suspected as primary diagnosis in emergency departments and still carries an in-hospital mortality rate of above 20%.</p><p><strong>Objectives: </strong>The aim of this study was to find differences in clinical and laboratory markers between patients with acute MVT and a control group of suspected but confirmed as not having any type of acute mesenteric ischaemia (AMI).</p><p><strong>Design: </strong>Data was retrieved from the AMESI (Acute MESenteric Ischaemia) study. This international, multicenter prospective case-control study from 32 sites collected data on patients with suspected AMI during a 10-month period.</p><p><strong>Methods: </strong>Independent factors associated with acute MVT were evaluated in a multivariable logistic regression analysis and expressed as odds ratios (OR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>D-dimer was not significantly higher in MVT (n = 73) compared to non-AMI (n = 287) patients (median 7.0 mg/L vs 4.5 mg/L, <i>P</i> = .092). After entering BMI, atherosclerotic disease, history of venous thromboembolism, CRP, and D-dimer as covariates in a multi-variable logistic regression analysis, absence of atherosclerotic disease (OR 0.096, 95% CI 0.011-0.84; <i>P</i> = .034) and elevated D-dimer (OR 2.59/one SD increment, 95% CI 1.07-6.28; <i>P</i> = .034) were associated with MVT. The discriminative ability of D-dimer for MVT as assessed by area under the curve in the receiver operating characteristics analysis was 0.63 (95% CI 0.49-0.78).</p><p><strong>Conclusion: </strong>Elevated D-dimer was associated with MVT, but the discriminative ability of D-dimer was poor. There is an urgent need to find a more accurate plasma biomarker for this condition.</p><p><strong>Trial registration: </strong>NCT05218863 (registered 19.01.2022).</p>\",\"PeriodicalId\":47060,\"journal\":{\"name\":\"Biomarker Insights\",\"volume\":\"19 \",\"pages\":\"11772719241296631\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-11-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590162/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Biomarker Insights\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/11772719241296631\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Biomarker Insights","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/11772719241296631","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
D-Dimer in Acute Mesenteric Venous Thrombosis: A Prospective Case-Control International Multicenter Study.
Background: Acute mesenteric venous thrombosis (MVT) is rarely suspected as primary diagnosis in emergency departments and still carries an in-hospital mortality rate of above 20%.
Objectives: The aim of this study was to find differences in clinical and laboratory markers between patients with acute MVT and a control group of suspected but confirmed as not having any type of acute mesenteric ischaemia (AMI).
Design: Data was retrieved from the AMESI (Acute MESenteric Ischaemia) study. This international, multicenter prospective case-control study from 32 sites collected data on patients with suspected AMI during a 10-month period.
Methods: Independent factors associated with acute MVT were evaluated in a multivariable logistic regression analysis and expressed as odds ratios (OR) with 95% confidence intervals (CI).
Results: D-dimer was not significantly higher in MVT (n = 73) compared to non-AMI (n = 287) patients (median 7.0 mg/L vs 4.5 mg/L, P = .092). After entering BMI, atherosclerotic disease, history of venous thromboembolism, CRP, and D-dimer as covariates in a multi-variable logistic regression analysis, absence of atherosclerotic disease (OR 0.096, 95% CI 0.011-0.84; P = .034) and elevated D-dimer (OR 2.59/one SD increment, 95% CI 1.07-6.28; P = .034) were associated with MVT. The discriminative ability of D-dimer for MVT as assessed by area under the curve in the receiver operating characteristics analysis was 0.63 (95% CI 0.49-0.78).
Conclusion: Elevated D-dimer was associated with MVT, but the discriminative ability of D-dimer was poor. There is an urgent need to find a more accurate plasma biomarker for this condition.
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