Spadaro A, Tortorella V, Morace C, Fortiguerra A, Composto P, Bonfiglio C, Alibrandi A, Luigiano C, Caro GD, Ajello A, Ferraù O, Freni MA. High circulating D-dimers are associated with ascites and hepatocellular carcinoma in liver cirrhosis. World J Gastroenterol 2008; 14(10): 1549-1552 [PMID: 18330946 DOI: 10.3748/wjg.14.1549]
Corresponding Author of This Article
Dr. Aldo Spadaro, Department of Medicine and Pharmacology, Clinica Medica, Pad C-University Hospital, Via Consolare Valeria, Messina 98125, Italy. aldo.spadaro@unime.it
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Rapid Communication
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World J Gastroenterol. Mar 14, 2008; 14(10): 1549-1552 Published online Mar 14, 2008. doi: 10.3748/wjg.14.1549
High circulating D-dimers are associated with ascites and hepatocellular carcinoma in liver cirrhosis
Aldo Spadaro, Vincenza Tortorella, Carmela Morace, Agostino Fortiguerra, Paola Composto, Caterina Bonfiglio, Angela Alibrandi, Carmelo Luigiano, Giuseppe De Caro, Antonino Ajello, Oscar Ferraù, Maria Antonietta Freni
Aldo Spadaro, Vincenza Tortorella, Carmela Morace, Agostino Fortiguerra, Paola Composto, Caterina Bonfiglio, Carmelo Luigiano, Giuseppe De Caro, Antonino Ajello, Oscar Ferraù, Maria Antonietta Freni, Department of Medicine and Pharmacology University Hospital, Messina 98125, Italy
Angela Alibrandi, Department of Statistics, University of Messina, Messina 98125, Italy
Author contributions: Spadaro A, Freni MA and Tortorella V designed research; Tortorella V, Morace C, Fortiguerra A, Composto P, Bonfiglio C, Luigiano C, De Caro G, Ajello A, Ferraù O performed research; Alibrandi A analyzed data; Freni MA, Spadaro A and Morace C wrote the paper.
Correspondence to: Dr. Aldo Spadaro, Department of Medicine and Pharmacology, Clinica Medica, Pad C-University Hospital, Via Consolare Valeria, Messina 98125, Italy. aldo.spadaro@unime.it
Telephone: + 39-90-2212333
Fax: + 39-90-693917
Received: August 29, 2007 Revised: January 24, 2008 Published online: March 14, 2008
Abstract
AIM: To measure plasma D-dimer levels in cirrhotic patients with and without ascites, assessing the effect of ascites resolution in D-dimer concentration.
METHODS: Seventy consecutive cirrhotic patients (M = 44, F = 26, mean age 65 years, SD ± 13), observed from October 2005 to March 2006 were enrolled. Circulating D-dimer levels were measured using a latex-enhanced, immunoturbidimetric test. In patients with ascites (n = 42) the test was repeated after ascites resolution.
RESULTS: Ascites was present in 42 patients (group A) and absent in 28 (group B). Group A patients had more advanced liver disease. Hepatocellular carcinoma (HCC) was diagnosed in 14 patients and was more frequent in group B. Above normal range D-dimers were found in 45/70 patients. High D-dimers were more frequent in group A than in group B (P = 0.001). High D-dimers were associated with presence of HCC (P = 0.048) only in group B. After ascites resolution, obtained in all patients, mean D-dimer values decreased in those 34 patients with high basal levels (P = 0.007), returning to normal in 17.
CONCLUSION: In patients with liver cirrhosis, ascites and HCC are the main factors associated with increased fibrinolytic activity.
