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Therapeutics
An abnormal D-dimer test result indicated that anticoagulant therapy should be continued

https://doi.org/10.1136/ebm.12.2.45

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    Palareti G, Cosmi B, Legnani C, et al. D-dimer testing to determine the duration of anticoagulation therapy. N Engl J Med 2006;355:1780–9.
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 Q In patients with a first episode of venous thromboembolism (VTE) who had received vitamin K antagonists for ⩾3 months, does an abnormal D-dimer test result 30 days after discontinuation of anticoagulation therapy predict VTE recurrence?

    Clinical impact ratings IM/Ambulatory care ★★★★★★★ Haematology ★★★★★★★

    METHODS

    Embedded ImageDesign:

    randomised controlled trial (PROLONG study).

    Embedded ImageAllocation:

    concealed.*

    Embedded ImageBlinding:

    blinded (outcome assessors {and monitoring committee}†).*

    Embedded ImageFollow up period:

    up to 18 months (mean 1.4 y).

    Embedded ImageSetting:

    30 clinical centres in Italy.

    Embedded ImagePatients:

    619 patients 18–85 years of age (mean age 63 y, 52% men) who had a first episode of symptomatic, unprovoked VTE, including proximal deep vein thrombosis of the lower limbs, pulmonary embolism, or both; had received a vitamin K antagonist (warfarin or acenocoumarol) for ⩾3 months with a target international normalised ratio (INR) of 2.5 (range 2.0–3.0); and had D-dimer testing 30 days after anticoagulation was discontinued. Exclusion criteria …

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    Footnotes

    • ↵* See glossary.

    • ↵† Information provided by author.

    • For correspondence: Dr G Palareti, S. Orsola-Malpighi University Hospital, Bologna, Italy. gualtiero.palareti{at}unibo.it

    • Source of funding: Italian Federation of Anticoagulation Clinics.

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