D Dimer Predicts Likelihood of Recurrent Venous Thromboembolism

Some studies suggest that D-dimer levels measured after discontinuation of oral anticoagulant therapy (OAT) may be useful for predicting the likelihood of recurrent venous thromboembolism (Thromb Haemost 2002; 87:7-12 and Circulation 2003; 108:313-318). One management strategy is to stop anticoagulation in patients with unprovoked venous thromboembolism after 3 months and measure D-dimer 1 month after cessation of anticoagulation. An elevated D-dimer level is an indication to restart anticoagulation, while a normal result along with the absence of other risk factors for recurrence provides support for discontinuing anticoagulation (Marshall AL, et al. JCOM 2015;22:222-240). D-dimer cutoffs of  0.25 or 0.50 ug/mL have been used for this purpose.