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Clinical Investigations: PULMONARY HYPERTENSION |

Significance of a Plasma D-dimer Test in Patients With Primary Pulmonary Hypertension*

David Shitrit, MD; Daniele Bendayan, MD; Ariella Bar-Gil-Shitrit, MD; Michael Huerta, MD, MPH; Bernard Rudensky, PhD; Gershon Fink, MD; Mordechai R. Kramer, MD, FCCP
Author and Funding Information

*From the Pulmonary Institute (Drs. Shitrit, Bendayan, Fink, and Kramer), Rabin Medical Center, Petach-Tiqwa, Israel; and Internal Medicine (Drs. Huerta and Bar-Gil-Shitrit) and Department of Clinical Laboratories (Dr. Rudensky), Shaare-Zedek Medical Center, Jerusalem, Israel.

Correspondence to: Mordechai R. Kramer, MD, FCCP, Pulmonary Institute, Rabin Medical Center, Beilinson Campus, Petach Tiqwa 49100, Israel; e-mail: pulm@netvision.net.il



Chest. 2002;122(5):1674-1678. doi:10.1378/chest.122.5.1674
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Background: D-dimer, a degradation product of fibrin, has been increasingly used as a marker or prognostic factor in various thrombotic diseases.

Objective: To assess the significance of a d-dimer test in patients with primary pulmonary hypertension (PPH).

Patients and methods: Fourteen patients with PPH (12 women and 2 men) aged 25 to 68 years (mean ± SD age, 50 ± 14 years) entered the study. Plasma d-dimer was determined by Miniquant assay (Biopool International; Venture, CA) 3 ± 5 months after the disease onset, and patients were followed up for 1 year. We compared the d-dimer levels to the demographic, clinical, and hemodynamic data of the patients.

Results: D-dimer levels were positively correlated with New York Heart Association classification (r = 0.59, p = 0.01) and pulmonary artery pressure (r = 0.43, p = 0.03) and were negatively correlated with oxygen saturation (r = − 0.45, p = 0.03) and 6-min walk distance (r = − 0.49, p = 0.04). One-year survival was also negatively correlated with d-dimer (point-biserial r = − 0.71, p = 0.004), with a higher d-dimer value associated with poorer survival. No significant correlations were found between d-dimer values and sex, age, diffusing capacity of the lung for carbon monoxide, or cardiac index.

Conclusion: D-dimer levels may have a role in the evaluation of patients with PPH. This simple, noninvasive test may be helpful for identifying patients who are at a higher risk for severe disease.

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