Aging Clinical and Experimental Research

, Volume 22, Issue 1, pp 20–23 | Cite as

Correlates of D-dimer in older persons

  • Freddy Tita-Nwa
  • Angelo Bos
  • Abdul Adjei
  • William B. Ershler
  • Dan L. Longo
  • Luigi Ferrucci
Original Articles


Background and aims: D-dimer is a marker of active fibrinolysis. Understanding how age-related factors affect D-dimer levels may help the interpretation of high D-dimer levels in older individuals. Methods: 776 Baltimore Longitudinal Study on Aging (BLSA) participants (mean age 68.4±13.9 yrs) were divided into three groups according to baseline D-dimer levels >200 ng/mL; 100–200 ng/mL and <100 ng/mL. Results: D-dimer level increased with age (p<0.0001). Using polychotomous logistic regression models, we found that age, cholesterol, triglycerides, creatinine, erythrocyte sedimentation rate, hemoglobin and body mass index were independently associated with D-dimer level. Conclusions: Rising levels of D-dimer with age can be explained in part by the high prevalence of pro-inflammatory conditions and increasing burden of lipid abnormalities, anemia and obesity. These factors compromise the specificity of D-dimer levels as a diagnostic aid to thrombosis in older individuals.


D-dimer inflammation obesity 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Michiels JJ, Palareti G, de Moerloose P (eds). Fibrin D-dimer testing for venous and arterial thrombotic disease. Semin Vasc Med. 2005; 5: 311–34.Google Scholar
  2. 2.
    Harper PL, Theakston E, Ahmed J, Ockelford P. D-dimer concentration increases with age reducing the clinical value of the D-dimer assay in the elderly. Intern Med J 2007; 37: 607–13.PubMedCrossRefGoogle Scholar
  3. 3.
    Lee AJ, Fowkes FG, Lowe GD, Rumley A. Determinants of fibrin D-dimer in the Edinburgh Artery Study. Arterioscler Thromb Vasc Biol 1995; 15: 1094–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Al-Zahrani H, Lowe GD, Fowkes FG, Douglas JT et al. Increased fibrin turnover in peripheral arterial disease: comparison with a population study. Clin Hemorheol 1992; 12: 867–72.Google Scholar
  5. 5.
    Giansante C, Fiotti N, Cattin L, Da Col PG, Calabrese S. Fibrinogen. D-dimer and thrombin-antithrombin complexes in a random population sample: relationships with other cardiovascular risk factors. Thromb Haemost 1994; 71: 581–6.Google Scholar
  6. 6.
    Shock NW, Gruelich RC, Andres RA et al. The Baltimore Longitudinal Study of Aging. Washington, DC: US Government Printing Office, 1984.Google Scholar
  7. 7.
    Talbot LA, Metter EJ, Fleg JL. Leisure-time physical activities and their relationship to cardiorespiratory fitness in healthy men and women 18–95 years old. Med Sci Sports Exerc 2000; 32: 417–25.PubMedCrossRefGoogle Scholar
  8. 8.
    Mavromatis BH, Kessler CM. D-Dimer testing: the role of the clinical laboratory in the diagnosis of pulmonary embolism. J Clin Pathol 2001; 54: 664–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Takefumi M, Hiroko K, Kazuomi K, Shunji S. Fibrin D-Dimer in thrombogenic disorders. Semin Thromb Hemost 2000; 26 (1).Google Scholar
  10. 10.
    Swartz JE, Jacobson BF, Connor MD, Bernstein PL, Fritz VU. Erythrocyte sedimentation rate as a marker of inflammation and ongoing coagulation in stroke and transient ischaemic attack. S Afr Med J 2005, 95: 607–12.PubMedGoogle Scholar
  11. 11.
    Reid D. The clinical role of fibrinogen and fibrin in peripheral arterial disease. MD Thesis, University of Glasgow, 1991.Google Scholar
  12. 12.
    Dacie JV, Lewis SM. Miscellaneous tests. In Dacie JV, Lewis SM, eds. Practical Haematology. London Churchill Livingstone 1995: 559–74.Google Scholar
  13. 13.
    Saadeh C. The erythrocytes sedimentation rate: old and new clinical applications. South Med J 1998, 91: 220–5.PubMedCrossRefGoogle Scholar
  14. 14.
    Righini M, Goehring C, Bounameaux H, Perrier A. Effects of age on the performance of common diagnostic tests for pulmonary embolism. Am J Med 2000; 109: 357–61.PubMedCrossRefGoogle Scholar
  15. 15.
    Righini M, Le Gal G, Perrier A, Bounameaux H. The challenge of diagnosing pulmonary embolism in elderly patients: influence of age on commonly used diagnostic tests strategies. J Am Geriatr Soc 2005; 53: 1039–45.PubMedCrossRefGoogle Scholar
  16. 16.
    Shutgens RE, Haas FJ, Biesma DH. Reduced efficacy of clinical probability score and D-dimer assay in elderly subjects suspected of having deep vein thrombosis. Br J Haematol 2005; 129: 653–7.CrossRefGoogle Scholar
  17. 17.
    Lowe GD. Fibrinogen. A cardiovascular risk factor, 2nd ed. Mannheim: Boehringer Mannheim, 1997.Google Scholar
  18. 18.
    Ernst E, Resch KL. Fibrinogen as a cardiovascular risk factor: a meta-analysis and review of the literature. Ann Intern Med 1993; 118: 956–63.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Internal Publishing Switzerland 2010

Authors and Affiliations

  • Freddy Tita-Nwa
    • 1
  • Angelo Bos
    • 1
  • Abdul Adjei
    • 2
  • William B. Ershler
    • 1
  • Dan L. Longo
    • 1
  • Luigi Ferrucci
    • 1
  1. 1.Clinical Research BranchNational Institute on Aging, National Institutes of HealthBaltimoreUSA
  2. 2.Health Disparities Section, Clinical Research BranchNational Institute on Aging, National Institutes of HealthBaltimoreUSA

Personalised recommendations