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

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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 ★★★★★★★


Embedded ImageDesign:

randomised controlled trial (PROLONG study).

Embedded ImageAllocation:


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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  • * See glossary.

  • Information provided by author.

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

  • Source of funding: Italian Federation of Anticoagulation Clinics.

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