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Plasma D‐dimer concentrations predicting stroke risk and rivaroxaban benefit in patients with heart failure and sinus rhythm: An analysis from the COMMANDER‐HF trial

European Journal of Heart Failure Sep 27, 2020

Ferreira JP, Lam CSP, Anker SD, et al. - Researchers intended to determine if there is a connection between D‐dimer levels and the risk of stroke and other thrombotic, bleeding and fatal events, and if D‐dimer concentrations could predict rivaroxaban 2.5mg/bd (vs placebo) effect in patients registered in the COMMANDER‐HF trial who were in sinus rhythm, had HFrEF and coronary artery disease. Baseline measurement of D‐dimer was available in 4,107 (82%) of 5,022 patients recruited. Data reported that the median (percentile25‐75) plasma concentration of D‐dimer was 360 (215‐665)ng/mL. Higher plasma D‐dimer concentrations were independently linked to higher rates of death, stroke, and venous thromboembolism. Rivaroxaban decreased the risk of stroke in COMMANDER‐HF but the advantage may be restricted to patients with D‐dimer concentrations above 515 ng/mL. Prospective trials to validate these results are required.

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