{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T13:21:20Z","timestamp":1765545680976},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ATVB"],"published-print":{"date-parts":[[1997,7]]},"abstract":"\n Abstract<\/jats:italic>\n The best anticoagulation level in patients with mechanical heart valve prostheses is still being debated. D-dimer, which detects the presence of cross-linked fibrin degradation products, has been demonstrated to be a useful marker of coagulation activation. This study was designed to verify whether heart valve prostheses in anticoagulated patients are associated with abnormalities in D-dimer plasma levels, and if so, whether such levels are related to the anticoagulation level and\/or whether they could be predictive of acute vascular or hemorrhagic events. In 132 patients with single and 10 with double mechanical valve replacement, international normalized ratio (INR) and D-dimer plasma levels were determined. The INR levels of the previous 8 months were reviewed to assess the time that each patient spent in the therapeutic range. The D-dimer plasma levels were compared with those obtained from 102 matched control subjects. The patients were then followed up for 2 years to record acute vascular and hemorrhagic events. For the entire group, D-dimer plasma levels in patients were the same as those in the control group. Patients with double valve replacement had higher D-dimer plasma levels than either monovalvular implant patients or control subjects. Patients who had spent <75% of the time within the assigned anticoagulation range had higher values for D-dimer plasma levels (median, 270 vs 198 ng\/mL,\n P<\/jats:italic>\n =.02). The major determinants of D-dimer plasma levels were age (\n R<\/jats:italic>\n 2<\/jats:sup>\n =.07,\n P<\/jats:italic>\n =.009) and the percentage of time spent below the predetermined INR level (\n R<\/jats:italic>\n 2<\/jats:sup>\n =.09,\n P<\/jats:italic>\n =.001). During follow-up, 19 acute vascular and 16 hemorrhagic events occurred. High D-dimer tertile was the only parameter predicting the occurrence of thromboembolic events. In patients with mechanical heart valve prostheses, the D-dimer plasma level depended on the thoroughness of anticoagulation. Patients in the upper tertile of D-dimer values have an \u22485-fold risk of vascular thromboembolic events. D-dimer determination can therefore be useful in detecting patients who are at a higher risk of severe vascular events.\n <\/jats:p>","DOI":"10.1161\/01.atv.17.7.1320","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T19:44:19Z","timestamp":1308339859000},"page":"1320-1324","source":"Crossref","is-referenced-by-count":8,"title":["D-Dimer and Anticoagulation in Patients With Mechanical Prosthetic Heart Valves"],"prefix":"10.1161","volume":"17","author":[{"given":"Carlo","family":"Giansante","sequence":"first","affiliation":[{"name":"From the Institute of Clinical Medicine, University of Trieste, and the Cardiovascular Centre, Ospedale Maggiore (C.P., S.S.), Trieste, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Fiotti","sequence":"additional","affiliation":[{"name":"From the Institute of Clinical Medicine, University of Trieste, and the Cardiovascular Centre, Ospedale Maggiore (C.P., S.S.), Trieste, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Calabrese","sequence":"additional","affiliation":[{"name":"From the Institute of Clinical Medicine, University of Trieste, and the Cardiovascular Centre, Ospedale Maggiore (C.P., S.S.), Trieste, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa","family":"La Verde","sequence":"additional","affiliation":[{"name":"From the Institute of Clinical Medicine, University of Trieste, and the Cardiovascular Centre, Ospedale Maggiore (C.P., S.S.), Trieste, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Pandullo","sequence":"additional","affiliation":[{"name":"From the Institute of Clinical Medicine, University of Trieste, and the Cardiovascular Centre, Ospedale Maggiore (C.P., S.S.), Trieste, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabino","family":"Scardi","sequence":"additional","affiliation":[{"name":"From the Institute of Clinical Medicine, University of Trieste, and the Cardiovascular Centre, Ospedale Maggiore (C.P., S.S.), Trieste, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianfranco","family":"Guarnieri","sequence":"additional","affiliation":[{"name":"From the Institute of Clinical Medicine, University of Trieste, and the Cardiovascular Centre, Ospedale Maggiore (C.P., S.S.), Trieste, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","first-page":"69","volume":"27","year":"1992","journal-title":"Hosp Pract (Off Ed)"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)63816-7"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1651604"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.100.6.1553"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)36724-8"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)36743-1"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199507063330103"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1649480"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.37.8.882"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90589-H"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.21.1.2105543"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(92)91448-I"},{"key":"e_1_3_2_13_2","first-page":"298","volume":"11","year":"1992","journal-title":"Int Angiol"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0049-3848(90)90273-F"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1642375"},{"key":"e_1_3_2_16_2","first-page":"177","volume":"23","year":"1993","journal-title":"J Cardiol"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.90.5.7955179"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1642486"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.73.6.527"},{"key":"e_1_3_2_20_2","unstructured":"Lee MH Mankowsky M McDonagh J. 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