Anti-Bacterial Agents ; therapeutic use ; Anticoagulants ; therapeutic use ; Arcanobacterium ; isolation & purification ; Humans ; Lemierre Syndrome ; drug therapy ; microbiology ; Male ; Middle Aged

BACKGROUNDIt is known that the main role of D-dimer has been as an exclusionary test in patients with suspected venous thromboembolism. However, the D-dimer is increasingly beginning to find clinical utility as a marker in the evaluation of the extent of the embolic disease. The aim of the study was to determine whether D-dimer levels predict the radiological markers of pulmonary embolism (PE) severity using Mastora score.

METHODSThis prospective study involved 69 patients with acute PE proved by computed tomography pulmonary angiography (CTPA). The D-dimer level was noted. A pulmonary artery obstruction index (PAOI; Mastora score) ≥ 21.3% indicated severe obstruction of PE. A right ventricle/left ventricle (RV/LV) ratio >0.9 indicated RV dysfunction.

RESULTSThe median D-dimer level and PAOI were 765 µg/L (95% CI: 750-1 205 µg/L) and 16.77% (95% CI: 16.32%-23.06%), respectively. The D-dimer level was positively correlated with PAOI (r = 0.417, P < 0.000 1). PAOI ≥ 21.3% was associated with high D-dimer levels (median, 993 µg/L (95% CI: 856-1 841 µg/L), Z = -2.991, P = 0.003). The D-dimer level was correlated with the RV/LV ratio (r = 0.272, P = 0.024). RV/LV ratios >0.9 were associated with high D-dimer levels (median, 880 µg/L (95% CI: 764-1 360 µg/L), Z = -2.070, P = 0.038). PAOI was positively correlated with the RV/LV ratio (r = 0.390, P = 0.001). After three months, both the PAOI and D-dimer levels decreased (Z = -7.009, P < 0.000 1; Z = -6.976, P < 0.000 1, respectively).

CONCLUSIOND-dimer levels are positively correlated with PE burden and right ventricle dysfunction on CTPA, and can help monitor the therapeutic response.

Adult ; Aged ; Angiography ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Humans ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Artery ; pathology ; Pulmonary Embolism ; diagnostic imaging ; metabolism ; pathology ; Tomography, X-Ray Computed ; Ventricular Dysfunction, Right ; diagnostic imaging ; metabolism ; pathology