• Pablo Demelo-Rodríguez, Marina López-Rubio, Crhistian-Mario Oblitas, Marta Olimpia Lago-Rodríguez, Lucía Gálvez-Rojas-Martín, and Francisco Galeano-Valle.
• Medicina Interna, Hospital General Universitario Gregorio Marañón, Madrid, España; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España; Instituto de investigación sanitaria Gregorio Marañón (IiSGM), Madrid, España.
• Med Clin (Barc). 2023 Mar 24; 160 (6): 253257253-257.

IntroductionD-dimer has a high negative predictive value for the diagnosis of venous thromboembolic disease (VTE). However, VTE has been reported in the presence of normal D-dimer values.MethodsThis is a prospective observational study in patients with VTE from Hospital Gregorio Marañón between 2001 and 2022, comparing the characteristics of clinical presentation based on D-dimer levels (<500 ng/mL vs. ≥500 ng/mL).ResultsA total of 2582 patients were found, 333 patients (12.9%) presented negative or weakly positive D-dimer levels. They were significantly younger (57.9 vs. 65.3 years), with a lower prevalence of comorbidities (ischemic heart disease, dementia, and chronic kidney disease), and a greater family history of VTE (8.4% vs. 5.2%) and thrombophilia (11.7% vs. 7.8%). They presented significantly less dyspnea (57.6% vs. 75.4%), syncope (3% vs. 13.5%), less thrombotic load, elevated NT-pro-BNP (22.0% vs. 48.2%), and right ventricle dilatation (8.1% vs. 30.0%).ConclusionPatients with VTE and low D-dimer levels at diagnosis were younger, with milder clinical presentation and lower thrombotic load; but they presented a higher prevalence of thrombophilia and a family history of VTE.Copyright © 2022 Elsevier España, S.L.U. All rights reserved.

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