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Effect of low-dose warfarin on D-dimer levels during sickle cell vaso-occlusive crisis: a brief report

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Ahmed S, Siddiqui AK, Iqbal U, Sison CP, Shahid RK, Sheth M, Patel DV, Russo LA. Effect of low-dose warfarin on D-dimer levels during sickle cell vaso-occlusive crisis: a brief report.

Eur J Haematol 2004: 72: 213–216. © Blackwell Munksgaard 2004 Abstract: Objective

: To evaluate the activation of clotting systems in patients with sickle cell disease (SCD) by measuring the plasma D-dimer level and to determine the effect of low-dose warfarin on D-dimer level during vaso-occlusive crisis. Methods

: Plasma D-dimer level was measured in 65 blood samples of 37 adult patients with SCD who were hospitalized for vaso-occlusive painful crisis. D-dimer level of patients who were on low-dose warfarin was compared with those patients who were not on any anticoagulation treatment. Analysis of variance (anova) was carried out to determine factors significantly associated with low D-dimer level in patients with SCD. The following factors were included in theanovamodel; warfarin, homozygous hemoglobin S, history of blood transfusion in past 3 months, hydroxyurea, hemoglobin S%, hemoglobin F%, white blood cell counts, hemoglobin level, platelet count, and plasma fibrinogen level. Results

: Overall median D-dimer level in 65 samples was 2.7 g fibrinogen equivalent units (FEU)/mL (0.34–4). Patients who were on low-dose warfarin had a median D-dimer level of 0.81 g FEU/mL (0.34–1.8) compared with 3.1 g FEU/mL (0.94–4) in those patients who were not on anticoagulation treatment. Usinganovato model D-dimer levels, only warfarin was significantly correlated with low D-dimer levels after controlling for other variables. Conclusions

: Patients with SCD during vaso-occulsive painful crisis have an elevated D-dimer level. Low-dose anticoagulation treatment is associated with a significant reduction in the D-dimer levels.
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Keywords: D-dimer level; low-dose warfarin; sickle cell disease; vaso-occlusive crisis

Document Type: Research Article

Affiliations: 1: Royal University Hospital, University of Saskatchewan, Saskatoon, Canada 2: Dartmouth General Hospital, Dalhousie University, Dartmouth, Canada 3: Long Island Jewish Medical Center, New Hyde Park, NY, USA 4: North Shore-LIJ Research Institute, Biostatistic Unit, Manhasset, NY, USA 5: Dow Medical College, Karachi, Pakistan

Publication date: March 1, 2004

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