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Serum D-dimer as a potential new biomarker for prognosis in patients with thrombotic thrombocytopenic purpura

Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disease, and its mortality rate is 10% to 20%. However, there are currently only a few markers to predict the prognosis in patients with TTP. We aimed to identify several clinical indices and laboratory parameters for predicting the pro...

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Autores principales: Wang, Hai-Xu, Han, Bing, Zhao, Ying-Ying, Kou, Lu, Guo, Lu-Lu, Sun, Tong-Wen, Song, Lai-Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220495/
https://www.ncbi.nlm.nih.gov/pubmed/32221074
http://dx.doi.org/10.1097/MD.0000000000019563
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author Wang, Hai-Xu
Han, Bing
Zhao, Ying-Ying
Kou, Lu
Guo, Lu-Lu
Sun, Tong-Wen
Song, Lai-Jun
author_facet Wang, Hai-Xu
Han, Bing
Zhao, Ying-Ying
Kou, Lu
Guo, Lu-Lu
Sun, Tong-Wen
Song, Lai-Jun
author_sort Wang, Hai-Xu
collection PubMed
description Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disease, and its mortality rate is 10% to 20%. However, there are currently only a few markers to predict the prognosis in patients with TTP. We aimed to identify several clinical indices and laboratory parameters for predicting the prognosis of TTP at admission. A single-centre observational cohort study that included patients with TTP from the First Affiliated Hospital of Zhengzhou University in China was conducted from January 1, 2012 to November 30, 2018. The primary outcome was prognosis, including in-hospital mortality, major thromboembolic events, or failure to achieve remission at discharge. We used the random forest method to identify the best set of predictors. Eighty-seven patients with TTP were identified, of whom 12 died during the treatment. The total number of patients within-hospital mortality, major thromboembolic events, and failure to achieve remission at discharge was 58. The machine learning method showed that the D-dimer level was the strongest predictor of the primary outcome. Receiver operating characteristic (ROC) analysis demonstrated that the sensitivity and specificity of the D-dimer level alone for identifying high-risk patients were 78% and 81%, respectively, with an optimum diagnostic cut-off value of 770 ng/mL. The area under the ROC curve (AUC) was 0.80, and the 95% confidence interval (CI) was 0.70 to 0.90. This study found that the D-dimer level exhibited a good predictive ability for prognosis in patients with TTP. These findings may aid in the development of new and intensive treatment strategies to achieve remission among high-risk patients. However, external validation is necessary to confirm the generalizability of our approach across populations and treatment practices.
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spelling pubmed-72204952020-06-15 Serum D-dimer as a potential new biomarker for prognosis in patients with thrombotic thrombocytopenic purpura Wang, Hai-Xu Han, Bing Zhao, Ying-Ying Kou, Lu Guo, Lu-Lu Sun, Tong-Wen Song, Lai-Jun Medicine (Baltimore) 4800 Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disease, and its mortality rate is 10% to 20%. However, there are currently only a few markers to predict the prognosis in patients with TTP. We aimed to identify several clinical indices and laboratory parameters for predicting the prognosis of TTP at admission. A single-centre observational cohort study that included patients with TTP from the First Affiliated Hospital of Zhengzhou University in China was conducted from January 1, 2012 to November 30, 2018. The primary outcome was prognosis, including in-hospital mortality, major thromboembolic events, or failure to achieve remission at discharge. We used the random forest method to identify the best set of predictors. Eighty-seven patients with TTP were identified, of whom 12 died during the treatment. The total number of patients within-hospital mortality, major thromboembolic events, and failure to achieve remission at discharge was 58. The machine learning method showed that the D-dimer level was the strongest predictor of the primary outcome. Receiver operating characteristic (ROC) analysis demonstrated that the sensitivity and specificity of the D-dimer level alone for identifying high-risk patients were 78% and 81%, respectively, with an optimum diagnostic cut-off value of 770 ng/mL. The area under the ROC curve (AUC) was 0.80, and the 95% confidence interval (CI) was 0.70 to 0.90. This study found that the D-dimer level exhibited a good predictive ability for prognosis in patients with TTP. These findings may aid in the development of new and intensive treatment strategies to achieve remission among high-risk patients. However, external validation is necessary to confirm the generalizability of our approach across populations and treatment practices. Wolters Kluwer Health 2020-03-27 /pmc/articles/PMC7220495/ /pubmed/32221074 http://dx.doi.org/10.1097/MD.0000000000019563 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 4800
Wang, Hai-Xu
Han, Bing
Zhao, Ying-Ying
Kou, Lu
Guo, Lu-Lu
Sun, Tong-Wen
Song, Lai-Jun
Serum D-dimer as a potential new biomarker for prognosis in patients with thrombotic thrombocytopenic purpura
title Serum D-dimer as a potential new biomarker for prognosis in patients with thrombotic thrombocytopenic purpura
title_full Serum D-dimer as a potential new biomarker for prognosis in patients with thrombotic thrombocytopenic purpura
title_fullStr Serum D-dimer as a potential new biomarker for prognosis in patients with thrombotic thrombocytopenic purpura
title_full_unstemmed Serum D-dimer as a potential new biomarker for prognosis in patients with thrombotic thrombocytopenic purpura
title_short Serum D-dimer as a potential new biomarker for prognosis in patients with thrombotic thrombocytopenic purpura
title_sort serum d-dimer as a potential new biomarker for prognosis in patients with thrombotic thrombocytopenic purpura
topic 4800
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220495/
https://www.ncbi.nlm.nih.gov/pubmed/32221074
http://dx.doi.org/10.1097/MD.0000000000019563
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