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Thrombosis
some studies did not confirm this observation.
49,50
Male sex is a
consistent predictor of recurrent VTE,
51,52
whereas the presence of
Domenico Prisco is a Full Professor of Internal
Medicine at the University of Florence School of
thrombophilic blood abnormalities does not seem to confer a clinically
Medicine in Italy. He is an internist and haematologist
important increased risk of recurrent VTE.
53–55
Ideally, DD should be part responsible for the Regional Thrombosis Reference
of a clinical prediction rule that incorporates both clinical and laboratory
Centre of Careggi University Hospital in Florence. He
is a member of the Italian Society of Internal
features to better predict recurrent VTE in an individual patient.
Medicine, the Italian Society of Angiology and Vascular
Pathology, the Italian Society of Haemostasis and
Conclusions
Thrombosis, the International Society of Cardiology
and the working group on thrombosis of the European Society of Cardiology (ESC).
In the setting of VTE, DD has gained an important place in the diagnostic
Professor Prisco is a former President of the Italian Society of Haemostasis and
work-up of suspected DVT or PE as a simple, non-invasive test that can Thrombosis and a former Council Member and Secretary of the Italian Federation
be useful to rule out the diagnosis, especially in combination with PCP
of Anticoagulation Clinics, and he is a member of a number of Italian boards that
are drawing up guidelines on thrombosis and haemostasis.
assessment, thus limiting the number of patients requiring further
evaluation with imaging techniques. The specificity and clinical utility of
Elisa Grifoni is an Attending Physician at the Thrombosis
DD testing to exclude VTE are reduced in specific patient populations
Centre of Careggi University Hospital in Florence. Her
and clinical settings, such as elderly patients, cancer patients, pregnant scientific activity in the Department of Medical and
women and patients with previous VTE, although the test retains its
Surgical Critical Care at the University of Florence is in
the field of thrombosis and haemostasis, with a focus
high sensitivity in these situations. Moreover, a DD result below the
on venous thromboembolism and anticoagulant
diagnostic cut-off obtained after starting anticoagulation or in patients therapy. She is a member of the Italian Society of
having symptoms for several days before testing should be carefully
Haemostasis and Thrombosis. Dr Grifoni received her
MD from the University of Florence in 2008.
interpreted in order to avoid false-negative results.
Daniela Poli works at the Thrombosis Centre of
There is increasing evidence that DD testing after anticoagulation Careggi University Hospital in Florence. Her scientific
withdrawal for a first unprovoked VTE episode may also be useful to
activity in the Department of Heart and Vessels at the
University of Florence is in the field of thrombosis and
discriminate between patients at higher and lower risk of recurrence,
haemostasis. She is the author of more than 40
and may therefore help clinicians with the decision of whether to papers and scientific reviews in national and
continue or to stop anticoagulant treatment. However, additional
international journals. She is a Board Member of the
Italian Federation of Anticoagulation Clinics, and is
research is needed to establish the optimal interval between stopping
involved in the production of the guidelines in the
anticoagulation and performing DD testing, to identify the optimal DD field of thrombosis and haemostasis on behalf of this organisation. Dr Poli
cut-off level that predicts recurrence and to develop a clinical
graduated from medical school at the University of Florence in 1984.
prediction rule for recurrent VTE. n
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40 EUROPEAN HAEMATOLOGY
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