Semin Vasc Med 2005; 05(4): 387-398
DOI: 10.1055/s-2005-922485
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Fibrin D-Dimer and Cardiovascular Risk

Gordon D.O Lowe1
  • 1Division of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
Further Information

Publication History

Publication Date:
22 November 2005 (online)


Fibrin D-dimer, the most commonly used clinical assay for detection of coagulation activation and in vivo fibrin formation and lysis in circulating blood, has been associated with risks of cardiovascular diseases in studies published over the past 15 years. This review discusses, in turn, analytic and preanalytic considerations; associations with risk factors; and associations with coronary heart disease, atrial fibrillation, stroke and cerebrovascular disease, peripheral arterial disease, and venous thromboembolism. These associations suggest that activated coagulation and in vivo fibrin formation and lysis may play a role in arterial, intracardiac, and venous thromboembolism. The potential clinical utility of D-dimer in prediction of cardiovascular risk, in indicating patient groups for prophylactic anticoagulation and in monitoring of anticoagulation, requires further study. Harmonization of results from different assays would increase clinical utility.


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  • 120 Woodward M, Lowe G D, Campbell D et al.. Associations of inflammatory and haemostatic variables with the risk of recurrent stroke.  Stroke. 2005;  , In press
  • 121 Smith F B, Lowe G D, Fowkes F G et al.. Smoking, haemostatic factors and lipid peroxides in a population case control study of peripheral artery disease.  Atherosclerosis. 1993;  102 155-162
  • 122 De Buyzere M, Philippe J, Duprez D, Baele G, Clement D L. Coagulation system activation and increase of D-dimer levels in peripheral arterial occlusive disease.  Am J Hematol. 1993;  43 91-94
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  • 124 Lee A J, Fowkes FGR, Rattray A, Rumley A, Lowe G D. Haemostatic and rheological factors in intermittent claudication: the influence of smoking and extent of arterial disease.  Br J Haematol. 1996;  92 226-230
  • 125 Woodburn K R, Lowe G D, Rumley A, Love J, Pollock J G. Relation of haemostatic, fibrinolytic, and rheological variables to the angiographic extent of peripheral arterial occlusive disease.  Int Angiol. 1995;  14 346-353
  • 126 Smith F B, Lee A J, Fowkes FGR, Rumley A, Lowe G D. Smoking, haemostatic factors and the severity of aorto-iliac and femoro-popliteal disease.  Thromb Haemost. 1996;  75 19-24
  • 127 Bini A, Kudryk B J. Fibrinogen, fibrin and atherosclerosis: vascular and systemic effects. In: Ernst E, Koenig W, Lowe GD, Meade T Fibrinogen: A “New” Cardiovascular Risk Factor. Vienna; Blackwell-MZV 1992: 41-45
  • 128 Smith E B, Keen G A, Grant A, Stirk C. Fate of fibrinogen in human arterial intima.  Arteriosclerosis. 1990;  10 263-275
  • 129 Lee A J, Fowkes FGR, Lowe G D, Rumley A. Haemostatic factors, atherosclerosis and risk of abdominal aortic aneurysm.  Blood Coagul Fibrinolysis. 1996;  7 695-701
  • 130 Smith F B, Rumley A, Lee A J, Leng G C, Fowkes FGR, Lowe G D. Haemostatic factors and prediction of ischaemic heart disease and stroke in claudicants.  Br J Haematol. 1998;  100 758-763
  • 131 Woodburn K R, Lowe G D, Pollock J G, Rumley A, Reid A W. Percutaneous angioplasty, endothelial markers, and fibrin turnover.  J Endovasc Surg. 1994;  1 53-60
  • 132 Jorgensen B, Nielsen J D, Norgard J, Helligso P, Baekgaard N, Egeblad M. Cross-linked fibrin degradation products as marker of early rethrombosis after percutaneous transluminal angioplasty.  Thromb Haemost. 1993;  69 1003
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  • 134 Andreescu ACM, Cushman M, Rosendaal F R. D-dimer as a risk factor for deep vein thrombosis: the Leiden thrombophilia study.  Thromb Haemost. 2002;  87 47-51
  • 135 Lowe G D. Prediction of postoperative venous thrombosis using haemostasis tests.  Int J Clin Lab Res. 1997;  27 153-157
  • 136 Palareti G, Legnani C, Cosmi B, Guazzaloca G, Pancani C, Coccheri S. Risk of venous thromboembolism recurrence: high negative predictive value of D-dimer performed after oral anticoagulation is stopped.  Thromb Haemost. 2002;  87 7-12
  • 137 Palareti G, Legnani C, Cosmi B et al.. Predictive value of D-dimer test for recurrent venous thromboembolism after anticoagulation withdrawal in subjects with a previous idiopathic event and in carriers of congenital thrombophilias.  Circulation. 2003;  108 313-318

Gordon D.O LoweM.D. F.R.C.P. 

Professor of Vascular Medicine, Division of Cardiovascular and Medical Sciences, University of Glasgow, Royal Infirmary, 3rd Floor, Queen Elizabeth Building

10 Alexandra Parade, Glasgow G31 2ER, United Kingdom