High circulating D-dimers are associated with ascites and hepatocellular carcinoma in liver cirrhosi

AIM:To measure plasma D-dimer levels in cirrhotic patients with and without ascites,assessing the effect of ascites resolution in D-dimer concentration.METHODS:Seventy consecutive cirrhotic patients(M=44,F=26,mean age 65 years,SD±13),observed from OdDber 2005 to March 2006 were enrolled.Circulating D-dimer Ievels were measured using a latex-enhanced,immunoturbidimetric test.In patients with ascites(,7=42)the test was repeated after ascites resolution.RESULTS:Ascites was present in 42 patients(group A)and absent in 28(group B).Group A patients had more advanced Iiver disease.Hepatocellular carcinoma(HCC)was diagnosed in 14 patients and was more frequent in group B.Above normaI range D-dimers were found in 45/70 patients.High D-dimers were more frequent in group A than in group B(P=0.001).High D-dimers were associated with presence of HCC(P=0.048)only in group B.Afber ascites resolution,obtained in all patienIs,mean D-dimer values decreased in those 34 patients with high basal levels(P=0.007),returning to normal in 17.CONCLUSION:In patients with Iiver cirrhosis,ascites and HCC are the main factors associated with increased fibrinolytic activiby.