Significance of plasma D-dimer in relation to the severity of atherosclerosis among patients evaluated by non-invasive indices of cardio-ankle vascular index and carotid intima-media thickness.

The aim of this study is to elucidate the usefulness of plasma D-dimer for the prediction of thrombotic events in highly atherosclerotic patients. The severity of atherosclerosis was measured by non-invasive methods including cardio-ankle vascular index (CAVI) and carotid intima-media thickness (IMT) in 100 patients with atherosclerosis aged 72.1 years on average. CAVI was significantly correlated with the levels of D-dimer, platelet aggregation (Plt Aggre), uric acid (UA), creatinine (Cr), blood urea nitrogen (BUN), and C-reactive protein (CRP), whereas IMT was significantly correlated with the levels of Cr, BUN, and CRP. CAVI and IMT were suitable for stratification of the patients. A comparison of hemostatic markers (D-dimer, fibrinogen and Plt Aggre) between the less sclerotic group (group A; CAVI <8.0 and IMT <1.1 mm, n = 26) and the highly sclerotic group (group B; CAVI >8.0 and IMT >1.1 mm, n = 32) revealed that the incidence of thrombosis was significantly higher in group B (18.8%) than in group A (3.8%) and that D-dimer was significantly higher (p < 0.01, Mann-Whitney U test) in group B (0.48 mug/ml, median) than in group A (0.32 mug/ml, median). Moreover, multiple linear regression analyses of CAVI and IMT indicated that D-dimer and age were significant variables. In conclusion, D-dimer is significantly associated with thrombosis in highly atherosclerotic patients.