D-dimer and CRP

D-Dimer and Inflammatory Markers Are Associated with Short-Term Mortality
But these findings must be replicated before they can be used clinically.

Thrombosis and inflammation are involved in the pathogenesis of acute cardiovascular events, but whether markers of these processes can predict short-term harm is unknown. Researchers studied the association between such markers and mortality in a prospective cohort of 377 patients with peripheral arterial disease. During 4 years of follow-up, 76 patients (20%) died; 31 died of cardiovascular disease.

Higher levels of D-dimer, C-reactive protein, and serum amyloid A were each associated significantly with higher all-cause mortality within 1 year, and from 1 to 2 years, but not 2 to 3 years after measurement, in survival analyses adjusted for age, sex, race, cardiovascular diseases, cancer, diabetes, smoking, and ankle-brachial index. A similar pattern was observed for cardiovascular mortality (except that D-dimer remained a significant predictor at 2 to 3 years).

Comment: Biomarkers such as those studied in this cohort have not been particularly useful for predicting long-term mortality because they have not added much information beyond that provided by more easily measured traditional risk factors. But if these findings are confirmed in other samples, these biomarkers could have use for predicting short-term outcomes.

— Richard Saitz, MD, MPH, FACP, FASAM

Published in Journal Watch General Medicine February 5, 2008

Citation(s): Vidula H et al. Biomarkers of inflammation and thrombosis as predictors of near-term mortality in patients with peripheral arterial disease: A cohort study. Ann Intern Med 2008 Jan 15; 148:85.